The Pharmaceutical Journal
Vol 269 No 7205 p9
6 July 2002

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Candesartan reduces risk of stroke in elderly

The angiotensin-II receptor antagonist candesartan (Amias) reduces the risk of non-fatal stroke in elderly patients with mild hypertension, researchers reported at a meeting of the International and European Societies of Hypertension held in Prague last week.

The results come from the SCOPE (study on cognition and prognosis in the elderly) trial, which was carried out in 15 countries, including the United Kingdom.

In the trial, 4,937 patients with treated or untreated hypertension, aged between 70 and 89 years, were assigned to receive either candesartan 8mg or placebo once daily.

Those patients whose blood pressure remained high were given additional antihypertensive treatment. The recommended add-on treatment was hydrochlorothiazide 12.5mg once daily and, of the patients in the placebo group, 84 per cent were assigned add-on treatment.

The researchers found that candesartan reduced the risk of non-fatal stroke by 28 per cent — non-fatal stroke occurred in 68 patients taking candesartan (n=2477) and 93 patients in the placebo group (n=2460).

They also found that patients taking candesartan had an 11 per cent risk reduction in major cardiovascular events (cardiovascular death, non-fatal myocardial infarction and non-fatal stroke) and showed a beneficial trend towards a delay in the onset of type II diabetes, although neither of these trends achieved statistical significance when compared with the control group.

Professor Gary Ford, University of Newcastle, and lead researcher for SCOPE in the UK, told The Journal that he thought that significance was not achieved in these cases because the add-on antihypertensive treatment received by patients in the placebo group had resulted in better blood pressure control than expected.

He commented that the results of the study confirm that blood pressure lowering in the elderly is beneficial in reducing stroke.

The researchers also found that cognitive function was maintained in patients taking candesartan despite that fact that lowering blood pressure in the elderly is thought to increase the rate of cognitive decline.