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Two Drugs Better Than One for High Blood Pressure
Date:3/31/2008

er still sold in the United States and the most widely prescribed in its class around the world. The drug carries a black-box warning about an increase in cardiovascular risks for users.

The authors reviewed existing data from several trials and combined them in one comprehensive analysis, finding a clear relationship between dose and cardiovascular risk.

Individuals taking 400 milligrams of Celebrex twice a day had a threefold increase in cardiovascular risk. Those taking 200 milligrams twice a day had double the risk.

In addition, patients who had a low risk when they started taking the painkiller continued to show a low risk of having a Celebrex-induced cardiovascular problem later, while those starting out at high risk were more likely to suffer cardiovascular consequences while taking Celebrex, especially at the higher doses. The analysis was published simultaneously Monday in the online edition of Circulation.

"Perhaps this will give us a little bit of comfort when we prescribe Celebrex to patients who are at very, very low cardiovascular risk, but it will perhaps make us considerably more cautious when prescribing to those at high risk," said study author Dr. Scott Solomon, director of noninvasive cardiology at Brigham and Women's Hospital in Boston. "The doses we were able to test were considerably higher than typical arthritis patients are taking."

A third study from the news conference brought more good news for Crestor (rosuvastatin). In a study funded by drug maker AstraZeneca, treatment with this statin for two years lowered average LDL ("bad") cholesterol levels and increased HDL ("good") cholesterol levels, resulting in regression of coronary atherosclerosis. Earlier Monday, AstraZeneca announced that it had halted another trial of Crestor because of "unequivocal" evidence that it was better than a placebo.

"Ninety-seven percent of participants were either stable or had regression," s
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