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With median follow-up of 6 years, simvastatin+ezetimibe was found to reduce the primary outcome of CV mortality, major CV event, or nonfatal stroke (34.7% vs. 32.7%; P=0.016; NNT 50 per 7 years or NNT 350 per 1 year ). There was no reduction in all-cause or CV mortality with simvastatin+ezetimibe, though there was a reduction in MI and stroke. [6]
Ezetimibe, sold under the brand name Zetia among others, is a medication used to treat high blood cholesterol and certain other lipid abnormalities. [ 3 ] [ 4 ] Generally it is used together with dietary changes and a statin . [ 5 ]
Simvastatin is an effective serum lipid-lowering drug that can decrease low density lipoprotein (LDL) levels by up to 50%. [citation needed] Simvastatin had been shown to interact with lipid-lowering transcription factor PPAR-alpha [36] and that interaction might control the neurotrophic action of the drug.
Managing cholesterol at the site of absorption is an increasingly popular strategy in the treatment of hypercholesterolemia [citation needed].Cholesterol absorption inhibitors are known to have a synergistic effect when combined a class of antihyperlipidemics called statins, to achieve an overall serum cholesterol target.
The exact mechanism responsible for the possible increased risk of diabetes mellitus associated with statin use is unclear. [105] However, recent findings have indicated the inhibition of HMGCoAR as a key mechanism. [109] Statins are thought to decrease cells' uptake of glucose from the bloodstream in response to the hormone insulin. [105]
Antihypertensive agents comprise multiple classes of compounds that are intended to manage hypertension (high blood pressure). Antihypertensive therapy aims to maintain a blood pressure goal of <140/90 mmHg in all patients, as well as to prevent the progression or recurrence of cardiovascular diseases (CVD) in hypertensive patients with established CVD. [2]