Results : BP and lipid levels tended to come together soon in the post-trial period .
Conclusion : Benefits of BPL and lipid lowering on all-cause and cardiovascular mortality were persistent , but attenuated , after discontinuation of r and omized treatment , indicating the importance of continuing therapy
Objective : Persistent long-term benefits after discontinuation of treatment have been suggested for blood pressure-lowering and lipid-lowering treatment .
We conducted a systematic review to assess the long-term effects of  blood pressure ( BP ) lowering ( BPL ) and lipid lowering on all-cause and cardiovascular mortality after discontinuation of r and omized treatment .
Long-Term Effects of Statin Treatment in Elderly People: Extended Follow-Up of the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER)
Background The PROspect i ve Study of Pravastatin in the Elderly at Risk ( PROSPER ) , a placebo-controlled trial of pravastatin , demonstrated a 19 % reduction in coronary outcomes ( p = 0.006 ) after a mean of 3.2 years , with no impact on stroke outcomes or all-cause mortality . However , there was a suggestion of increased cancer risk . Our aim is to determine the long-term benefits and safety of pravastatin treatment in older people using post-trial follow-up of the PROSPER participants . Methods 5,804 ( 2,520 Scottish ) men and women aged 70–82 years with either pre-existing vascular disease or increased risk of such disease because of smoking , hypertension or diabetes , were r and omised to 40 mg pravastatin or matching placebo . Using record linkage to routinely collected health records , all participants ( full cohort ) were linked to death and cancer registries , and the Scottish cohort additionally to hospital admissions , to provide composite fatal/non-fatal cardiovascular outcomes ( total mean follow-up 8.6 years ) . Results Pravastatin treatment for 3.2 years reduced CHD death in the full cohort , hazard ratio ( HR ) 0.80 , 95 % confidence interval ( CI ) 0.68–0.95 , p = 0.0091 and fatal coronary events or coronary hospitalisations in the Scottish cohort ( HR 0.81 , 95 % CI 0.69–0.95 , p = 0.0081 ) over 8.6 years . There was no reduction in stroke or all-cause mortality . Cancer risk was not increased in the full cohort ( HR 1.08 , 95 % CI 0.96–1.21 , p = 0.22 ) . Conclusions Pravastatin treatment of elderly high-risk subjects for 3.2 years provided long-term protection against CHD events and CHD mortality . However , this was not associated with any increase in life expectancy , possibly due to competing mortality with deaths from other causes . There was no evidence of long-term increased risk of cancer . Trial registration IS RCT N40976937
Results : BP and lipid levels tended to come together soon in the post-trial period .
Conclusion : Benefits of BPL and lipid lowering on all-cause and cardiovascular mortality were persistent , but attenuated , after discontinuation of r and omized treatment , indicating the importance of continuing therapy
Objective : Persistent long-term benefits after discontinuation of treatment have been suggested for blood pressure-lowering and lipid-lowering treatment .
We conducted a systematic review to assess the long-term effects of  blood pressure ( BP ) lowering ( BPL ) and lipid lowering on all-cause and cardiovascular mortality after discontinuation of r and omized treatment .