The Anglo-Scandinavian Cardiac Outcomes Trial and related studies

The results of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) have influenced national and international guidelines for blood pressure and lipid lowering. Imperial BRC supported the core clinical academic salaries and clinical research infrastructure such as Imperial Clinical Trials Unit (ICTU) and the Imperial BRC Genomics Facility.

Subsequent to the trial reports, major sub-studies have identified new physiological, biochemical and genetic markers predicting cardiovascular outcomes in hypertensive subjects. Long-term blood pressure variability, N-terminal brain natriuretic peptide and candidate genes identified by the genome-wide association study (GWAS) have been shown to be important independent predictors of future coronary and stroke events.

These studies have advanced our knowledge of disease mechanisms, identified new targets for intervention, and contributed to advances in personalised treatment. Long-term follow-up studies are in progress, the results of which will contribute to our understanding of the legacy effects of lipid lowering with statins.

Investigations on this cohort are following up the observation that levels of serum immunoglobulins (IgG and IgM) have a strong inverse relation to major adverse coronary events in humans, independent from other routinely measured risk factors. An immunoglobulins test is done to measure the level of immunoglobulins, also known as antibodies, in your blood.

Further investigation of the major potential problem of adverse events associated with statin use is ongoing, the outcomes of which will have significant impact on clinical practice. New studies have been initiated with monoclonal antibodies to PCSK9 – a major international clinical trial with related sub-studies.

  • Professor Peter Sever
    Professor Peter Sever
    Professor of Clinical Pharmacology & Therapeutics