Los Angeles—Two or more drugs are better than one when it comes to reducing first-time strokes.

That’s according to a presentation at the recent American Stroke Association’s International Stroke Conference 2018 in Los Angeles. Researchers report that a combination of an antihypertensive with a cholesterol-reducing agent reduced first-time strokes by 44%.

The study points out that 75% of strokes are first-time and that high blood pressure and high cholesterol are known to be risk factors. What was unknown was the protective effect of combining drugs that lower blood pressure and cholesterol levels.

A study team led by researchers from McMaster University in Hamilton, Ontario, focused on 1,705 participants from 21 countries to show that the drugs, which work well individually, offer even greater protection when combined. They found that daily doses of two blood pressure drugs—fixed-dose candesartan and hydrochlorothiazide—along with low-dose rosuvastatin, proved most effective, reaching a 44% reduction of stroke-risk level in patients at intermediate risk for heart disease.

Candesartan at 16 mg combined with 12.5 mg of hydrochlorothiazide every day was found to reduce stroke risk by 42% for those with blood pressure readings of 143.5 mm Hg or higher. In addition, compared with a placebo, the researchers determined that stroke was reduced by 30% among participants taking daily doses of 10 mg of rosuvastatin.

“These results indicate that to prevent stroke in those at moderate risk, blood pressure lowering plus cholesterol-lowering should be considered in those with elevated blood pressure, and cholesterol-lowering should definitely be considered for all,” explained lead author Jackie Bosch, PhD.  “These are existing drugs that are well-tolerated, have strong safety profiles and it is easy for patients to stick with them.”

In the Heart Outcomes Prevention Evaluation Study, the average age of the mostly male participants was 66 years. During an average follow-up of 5.6 years, 66 strokes occurred among the study group, which had an average initial blood pressure of 138/82 mm Hg. 

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