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 effectiveness and safety of pravastatin in 9014 patients with coronary heart disease and average cholesterol concentrations: the LIPID trial follow-up
BACKGROUND The Long-term Intervention with Pravastatin in Ischaemic Disease ( LIPID ) study showed that pravastatin therapy over 6 years reduced mortality and cardiovascular events in patients with previous acute coronary syndromes and average cholesterol concentrations . We assessed the longer-term effects of initial treatment with pravastatin on further cardiovascular events and mortality over a total follow-up period of 8 years . METHODS In the main trial , 9014 patients with previous myocardial infa rct ion or unstable angina and a baseline plasma cholesterol concentration of 4.0 - 7.0 mmol/L were r and omly assigned  pravastatin 40 mg daily or placebo and followed up for 6 years . Subsequently , all patients were offered open-label pravastatin for 2 more years . Major cardiovascular events and adverse events were compared according to initial treatment assignment . FINDINGS 7680 ( 97 % of those still alive ) had 2 years of extended follow-up . 3766 ( 86 % ) of those assigned placebo and 3914 ( 88 % ) assigned pravastatin agreed to take open-label pravastatin . During this period , patients originally assigned pravastatin had almost identical cholesterol concentrations to those assigned placebo , but a lower risk of death from all causes ( 219 [ 5.6 % ] vs 255 [ 6.8 % ] , p=0.029 ) , coronary heart disease ( CHD ) death ( 108 [ 2.8 % ] vs 137 [ 3.6 % ] , p=0.026 ) , and CHD death or non-fatal myocardial infa rct ion ( 176 [ 4.5 % ] vs 196 [ 5.2 % ] , p=0.08 ) . Over the total 8-year period , all-cause mortality was 888 ( 19.7 % ) in the group originally assigned placebo and 717 ( 15.9 % ) in the group originally assigned pravastatin , CHD mortality was 510 ( 11.3 % ) versus 395 ( 8.8 % ) , myocardial infa rct ion was 570 ( 12.7 % ) versus 435 ( 9.6 % ; each p < 0.0001 ) , and stroke was 272 ( 6.0 % ) versus 224 ( 5.0 % ; p=0.015 ) . Stronger evidence of separate treatment benefits than in the main trial was seen in important prespecified subgroups ( women , patients aged > or = 70 years , and those with total cholesterol < 5.5 mmol/L ) . Pravastatin had no significant adverse effects . INTERPRETATION The evidence of sustained treatment benefits and safety of long-term pravastatin treatment reinforces the importance of long-term cholesterol-lowering  treatment for almost all patients with previous CHD events
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 .