SPARCL: Subanalysis to Determine Lipid & BP Goal Achievement

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12 Dec, 10

SPARCL Subanalysis to Determine Lipid & BP Goal Achievement

Introduction

Attaining lipid and BP goals yields additive risk reduction in recurrent stroke and major CV events in patients with stroke or TIA: Analysis of SPARCL trial

Aim

To evaluate the benefits of lipid and blood pressure (BP) control in patients with stroke or transient ischemic attack (TIA).

Methods

Analysis of Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial

Patients

Stroke or TIA (N=4731)

Outcome measure

Attainment of lipid and BP goals, defined as:

  1. LDL cholesterol <70 mg/dl
  2. HDL cholesterol >50 mg/dl
  3. Triglycerides <150 mg/dl
  4. BP 120/80 mm Hg

Mean Follow-up Period

4.9 years

Results

  • Attainment of each goal yielded additional risk reduction in stroke; with 65% risk reduction observed in those who attained all goals vs. those who did not achieve any goal (Figure)
Figure. Risk reduction in stroke with attainment of lipid and BP goals

  • Patients attaining all the four goals also experienced 75% reduction in risk of major CV events

Conclusion

Optimal control of lipids and BP yields stepwise reduction in risk of stroke and major CV events in patients with stroke or TIA.

"The take-home message for the clinician is that better control of LDL cholesterol, triglycerides, and blood pressure, and higher levels of HDL cholesterol, especially when in combination, results in much-reduced recurrent stroke risk and major cardiovascular event rates in patients with a history of recent stroke."

-Dr Philip B Gorelick, University of Illinois College of Medicine, Chicago

Adapted from http://www.theheart.org/article/965381.do#bib_1. As accessed on May 4, 2009