← Antiplatelet & anticoagulant × blood pressure

SynthesisJAMA cardiology2016

Drugs for Primary Prevention of Atherosclerotic Cardiovascular Disease: An Overview of Systematic Reviews.

Kunal N Karmali et al.PubMed ↗Full text ↗Publisher ↗

  • BP-lowering therapylooks good hereLower coronary heart disease.Randomised, small.
  • Statinsno clear effectNo clear effect on overall risk for adverse effects.Nothing cleared the noise.

What the trial testedrandomised · 2016

Randomised vs placebo

Probably lowered coronary heart disease

−16%−21% to −10%

BP-lowering therapy vs placebo

Bigger than 4 in 10 on the map

As reported

RR 0.84, 95% CI 0.79–0.90

Randomised comparison

Probably reduced cardiovascular events

−36%−44% to −27%

Bigger than 8 in 10 for cardiovascular events

As reported

RR 0.64, 95% CI 0.56–0.73

Randomised comparison

Probably raised adverse events & safety

+54%+30% to +82%

Bigger than 7 in 10 for adverse events & safety

As reported

RR 1.54, 95% CI 1.30–1.82

Range includes no effect

No clear effect on overall risk for adverse effects

+0%−3% to +3%

statins vs placebo

Smaller than almost all for adverse events & safety

As reported

RR 1.00, 95% CI 0.97–1.03

Who was studied, and how

people with hypertension, in this paper

The trial randomly assignedassigned by chance

BP-lowering therapy
placebo

Probably lowered coronary heart disease−16%

randomised

The trial randomly assignedassigned by chance

statins
placebo

No clear effect on overall risk for adverse effects+0%

randomised

the abstract, start to end

… the risk for coronary heart disease (RR, 0.84; 95% CI, 0.79-0.90) and stroke (RR, 0.64; 95% CI, 0.56-0.73).

… the risk for major bleeding (RR, 1.54; 95% CI, 1.30-1.82), and statins did not increase overall risk for adverse effects (RR, 1.00; 95% CI, 0.97-1.03).

← favours treatmentfavours comparator →
could be chance
Coronary heart diseaseBP-lowering therapy vs placebo
RR 0.840.79–0.90
Cardiovascular events
RR 0.640.56–0.73
Adverse events & safety
RR 1.541.30–1.82
Overall risk for adverse effectsstatins vs placebo
RR 1.000.97–1.03
StatinsAntiplatelet & anticoagulantBlood pressureCardiovascular eventsAdverse events & safety

Statins × adverse events & safetyharms?mixed

unlikelylikely
0.16not counted
← favours comparatorfavours treatment →
more certainless certain
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Full record →Abstract, authors, funding and every citing paper · PMID 27438118