The EVAPE study (Exploring Vascular Protective Effects)

Abstract

Background:Preventive therapy of cardiovascular (cv) events is changing clinical practice, providing their effectiveness, according to the results of international randomized trials. The new antihypertensive agents, statins, and antiplatelet treatment account for significant relative risk reduction. Objectives: To evaluate, comparatively and retrospectively, cv death risk reduction associated to those medications, in patients submitted to conventional primary health care; to evaluate therapeutic associations and additional benefits of concomitant medications; to explore risk factors contribution to vascular death. Design: Cases and controls study, based on usual patterns of medication for cv disease (statins, antihypertensive agents or antiplatelet treatment), was designed to evaluate cv death risk reduction in a minimum of a one-year period of fully prescription. A total of 402 patients were assigned and distributed as cases and controls: cases were identified from health centre obit data base, including all individuals whose death occurred in the years 2003 and 2004, registered as related with vascular cause; controls were randomized after selection of patients with successive appointments to their family doctors in the last few years; homogeneity as for sex and age was granted. Statistics methods: Qui square for testing homogeneity by sex, age and risk factors distribution; Odds Ratio (OR) for risk estimate of death from vascular cause by therapeutic group and by risk factors; Logistic regression (OR adjusted for risk factors). 95% confidence interval. Results: Statins shown in this study to be associated to cv death risk (relative risk reduction estimate: 65 to 81%). Conclusions: The results suggest that, in the patients involved, statins have contributed to important and significant cv death risk reduction; «smoke» and previous cv events were the prominent risk factors.