Anglo Scandinavian Cardiac Outcomes Trial

In high-risk individuals and groups people with clinical evidence of macrovascular disease other than CHD, the Heart Protection Study (HPS) (II) with diabetes, the HPS and Collaborative Atorvastatin Diabetes Study (CARDS) (12) the elderly, Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) (13) or with hypertension, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) (14) and Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) (15). 

I 5 Sever PS, Dahlof B, Poulter NR, et al, Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA) a multicentre randomised controlled trial, Lancet 2003 361 1 149-1 158. 

Dahlof B, Sever PS, Poulter NR et al. for the ASCOT investigators (2005) Prevention of cardiovascular events with an anti hypertensive regimen, in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Lancet 366 895-906. 

Conversely, the much-touted ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) study found that treating with beta blockers, diuretics, or both increased the risk of developing diabetes by about 40 percent and had some other side effects as well. 

The diabetes subgroup (n = 2532) from the Anglo Scandinavian Cardiac Outcomes Trial Lipid-Lowering Arm (ASCOT-LLA) showed a similar trend (test for heterogeneity not significant) to reduction of CVD events as those without diabetes. This nial is of particular interest because the benefits of statin therapy (atorvastatin 10 mg/day) were seen in well-ffeated hypertensive patients [51]. 

---