A post hoc analysis of data from the Study on Cognition and Prognosis in the Elderly (SCOPE) suggests that candesartan cilexitil (Generic Atacand, AstraZeneca), an angiotensin receptor blocker, significantly reduces major cardiovascular events in the elderly, the cardiovascular mortality rate, and the total mortality rate.
At the annual meeting of the European Society of Hypertension, the researchers said that their reanalysis reflected the original intent of the study—which was to compare candesartan and placebo; for ethical reasons, however, candesartan and other antihypertensive treatments were also compared.
Patients in the three-step trial first received 8 mg of candesartan or placebo. In the second step, they received 16 mg of candesartan or placebo. In the third step, another drug could be added, including open-label antihypertensive treatment.
The researchers compared outcomes among the 1,253 drug candesarta and 845 placebo patients who did not receive addon therapy. The final difference in blood pressure reduction was 4.7 mm Hg in the treatment group and 2.6 mm Hg in the placebo group. The relative risk of a major cardiovascular event was 0.68; of cardiovascular mortality, 0.71; and of total mortality, 0.73.