Hope for primary cardiovascular prevention with the HOPE (Heart Outcomes Prevention Evaluation)-3 trial findings.

The HOPE-3 investigators enrolled 12,705 intermediate-risk participants in 21 countries in a 2-by-2 factorial trial. Subjects were randomized to receive a fixed dose of rosuvastatin or placebo, candesartan plus hydrochlorothiazide daily or placebo, and a third group received combination of antihypertensive and statins versus double placebo. The median follow-up was 5.6 years. The combination of antihypertensive and statin therapy was associated with a significantly lower rate of cardiovascular events than dual placebo. Statin therapy alone was also associated with improved outcome, while antihypertensive therapy had no added benefit compared to placebo.