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Long-Term Follow-up of the West of Scotland Coronary Prevention Study
Open accessAbstract
BACKGROUND: The West of Scotland Coronary Prevention Study was a randomized clinical trial comparing pravastatin with placebo in men with hypercholesterolemia who did not have a history of myocardial infarction, with an average follow-up of approximately 5 years. The combined outcome of death from definite coronary heart disease or definite nonfatal myocardial infarction was reduced from 7.9 to 5.5% (P<0.001) in the treatment group. Extended follow-up data were obtained for approximately 10 years after completion of the trial. METHODS: For the survivors of the trial, all deaths, hospitalizations and deaths due to coronary events and stroke, and incident cancers and deaths from cancer were tracked with the use of a national computerized record-linkage system. The results were analyzed with time-to-event analyses and use of Cox proportional-hazards models. RESULTS: Five years after the trial ended, 38.7% of the original statin group and 35.2% of the original placebo group were being treated with a statin. In the period approximately 10 years after completion of the trial, the risk of death from coronary heart disease or nonfatal myocardial infarction was 10.3% in the placebo group and 8.6% in the pravastatin group (P=0.02); over the entire follow-up period, the rate was 15.5% in the placebo group and 11.8% in the pravastatin group (P<0.001). Similar percentage reductions were seen in the combined rate of death from coronary heart disease and hospitalization for coronary events for both periods. The rate of death from cardiovascular causes was reduced (P=0.01), as was the rate of death from any cause (P=0.03), over the entire follow-up period. There were no excess deaths from noncardiovascular causes or excess fatal or incident cancers. CONCLUSIONS: In this analysis, 5 years of treatment with pravastatin was associated with a significant reduction in coronary events for a subsequent 10 years in men with hypercholesterolemia who did not have a history of myocardial infarction.
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“The effect of blood-pressure reduction on cardiovascular end points usually occurs within months, 26,27 whereas the effect of lipid lowering is evident after 1 to 2 years.8,28,29”
From Effect of a multifactorial intervention on mortality in type 2 diabetes (2008) · cites this paper as [26]
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“Whereas much of the research has been conducted on aerobic exercise, increasing amounts of evidence from the general population indicates that strength and resistance training or 'high intensity interval training can produce a multitude of beneficial effects, for both metabolic and mental health.288-290”
From The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness (2019) · cites this paper as [288]
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Metadata
- Authors
- Ford, I., Murray, H., Packard, C. J., Shepherd, J., Macfarlane, P. W., & Cobbe, S. M.
- Affiliations
- University of Glasgow (GB)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2007-10-11
- Volume
- 357
- Issue
- 15
- Pages
- 1477-1486
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W1973491874
- Cited by
- 416
- References
- 23
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 9 · 2021: 9 · 2020: 7 · 2019: 14 · 2018: 23 · 2017: 26 · 2016: 29 · 2015: 19 · 2014: 34 · 2013: 46 · 2012: 28
- FWCI
- 36.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- pravastatin, statins, hypercholesterolemia, coronary artery disease, myocardial infarction, long-term follow-up, secondary prevention, cardiovascular mortality, cancer incidence, men
- MeSH terms
- Anticholesteremic Agents, Coronary Disease, Follow-Up Studies, Humans, Hypercholesterolemia, Male, Middle Aged, Myocardial Infarction, Pravastatin, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Kaplan-Meier Estimate
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