Estimated reductions in cardiovascular risk for those remaining on treatment.

*See Methods. Proportional
effects from systematic reviews[5], [17],
[20] and given by (1-RR)*100%,
where RR is relative risk. Proportional effects of BP and
cholesterol lowering emerge fully after about a year and may vary
slightly by age; those for 60–69 year group shown here.
¶Proportional effects of blood pressure lowering on haemorrhagic
stroke and ischaemic stroke assumed to be the same as for total
stroke, as most trials have not reported on stroke subtypes. No
effect of statins on haemorrhagic stroke is assumed, reflecting the
overall results from statin trials.8
§Any major event  =  CHD, ischaemic stroke,
haemorrhagic stroke or major extra-cranial bleed. Assumes
pre-treatment annual rates of CHD, ischaemic stroke, haemorrhagic
stroke and major extra-cranial bleed of 1.0%, 0.6%,
0.1%, and 0.2% (ie. moderate risk - the average for
this trial population[13], [20], [51], [52])
and of 4.0%, 3.0%, 0.3% and 0.4% (high
risk - expected for people with symptomatic coronary artery
disease[29], [53]). These event
rates will vary according to many factors, especially age and
disease history.
Footnote: Trials indicate this formulation would also affect other
vascular and related outcomes, but in most patient populations these
would have less clinical impact due to lower incidence and/or
severity. Blood pressure lowering would reduce heart failure
incidence (by about a quarter), headache and renal events;[17],
[54], [55], [56]aspirin would reduce venous
thromboembolism.[57;, 1994 #1665] An approximately neutral
overall effect on diabetes incidence is expected: ACE-inhibitors
reduce risk[58] but this would be offset by small
increases in risk conferred by the low-dose thiazide[59]
and statin.[60] Effects on major non-vascular events
would also occur, but similarly the absolute effects would mostly be
small: the thiazide would reduce renal calculus and fracture, and
increase gout;[17], [54] the statin will
cause rhabdomyolysis (in less than 1 per 10,000 patient years[61])
and long-term aspirin can be expected to reduce gastrointestinal
cancer by about one-third and all solid cancers by about
one-fifth.[62]