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Abstract
Background: There have been few treatment studies examining whether risk factor modification among individuals with prehypertension (120–139/80–89 mm Hg) is beneficial in reducing clinical measures of cardiovascular disease.
Methods: We examined the effect of cholesterol reduction with cholestyramine on coronary heart disease (CHD) among prehypertensive men in a secondary analysis of the Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT). 828 participants were randomized to placebo and 853 to cholestyramine. The two outcomes were definite CHD (i.e., death and/or definite non-fatal myocardial infarction (MI)), and any CHD (i.e., definite CHD death and/or definite non-fatal MI and/or suspect CHD death and/or suspect MI).
Results: Cholestyramine use was associated with a 22% reduced risk of any CHD among prehypertensive men, Hazard ratio [HR] = 0.78; 95% Confidence Interval [CI]: 0.59 – 1.03, and absolute risk reduction of 3.2% (p = 0.05). The number needed to treat was 31.
Conclusion: Intervention appears beneficial among prehypertensive individuals. Confirmatory studies specifically targeted to prehypertensive individuals for the prevention of CHD are warranted.
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