Reducing Hypertension in the Elderly Leads to a Significant Reduction in the Incidence of Stroke.

Business Editors, Health/Medical Writers

The AT(1)-Receptor Blocker, Candesartan Cilexetil Significantly

Reduces the Incidence of Non-Fatal Strokes in Elderly Patients

With Mild Hypertension While Maintaining Cognitive Function

Results from the SCOPE(a) study, examining the effect of antihypertensive treatment in elderly patients with mild hypertension, are presented for the first time today at the joint meeting of the International Society of Hypertension and the European Society of Hypertension, Prague.

These results show a significant 28% risk reduction (p=0.041) in non-fatal strokes in elderly people with mild hypertension -- an often untreated group -- when treated with the AT(1)-receptor blocker, candesartan cilexetil, compared to the control group.

SCOPE also reported a non-significant trend to reduced risk (11% risk reduction; p=0.19) in the candesartan cilexetil treatment group, of major CV events; defined as a combined endpoint of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke. Lowering blood pressure was associated with maintained cognitive function, as measured by the MMSE (Mini Mental State Examination). There was no significant difference in the risk of heart attacks or cardiovascular death between treatment groups.

"SCOPE is a unique study," explains Professor Lennart Hansson, co-chair of the SCOPE Steering Committee. "It shows for the first time that treating mild hypertension in elderly people may have benefits on two counts. Reducing blood pressure with candesartan cilexetil offers real clinical benefits by significantly cutting people's risk of a non-fatal stroke."

"Importantly and perhaps contrary to current beliefs, SCOPE also shows that reducing blood pressure does not increase the risk of cognitive decline or the development of dementia in elderly people," continues Professor Hans Lithell.

"These results have important implications for how we currently view and treat elderly patients with mild hypertension."

Interestingly, in addition to the positive effect on stroke, candesartan cilexetil also demonstrated a beneficial trend in onset of new diabetes (20% risk reduction; p=0.083).

Hypertension, or high blood pressure, is the most common cardiovascular disorder(i). The World Health Organization estimates that there are nearly 691 million people throughout the world with hypertensive disease(i). The prevalence of high blood pressure (the number of people with the condition at any one time) is reported to be about 20 per cent of adult populations around the world(i). This figure is considerably higher in elderly people, and a prevalence of more than 50% has been reported.

SCOPE results are based on a randomized, double-blind, study in 15 countries to evaluate the effects of the AT(1)-receptor blocker, candesartan cilexetil, on the clinical outcomes of 4,937 elderly patients (aged 70-89, average 76 years ) with mild hypertension -- typical of those found in everyday practice.

Candesartan cilexetil has an established track record in blood pressure reduction with proven efficacy and placebo-like tolerability. Candesartan cilexetil has accumulated some 4.2 million patient years of clinical experience. Previous studies have shown candesartan cilexetil's efficacy in the treatment of hypertension -- with studies showing superior efficacy to losartan(ii)(iii), valsartan(iv), hydrochlorothiazide(v) and enalapril(vi) and equivalent efficacy to amlodipine(vii)(viii). Candesartan cilexetil also has placebo-like tolerability(ix) and is effective and well tolerated in elderly patients(x).

SCOPE study was sponsored and conducted by AstraZeneca.

Candesartan cilexetil was discovered and originally synthesized by Takeda Chemical Industries, Ltd., and it was jointly developed with AstraZeneca.

Candesartan Cilexetil is marketed worldwide under the brand name of Blopress(R) by Takeda and Atacand(R) by AstraZeneca in more than 50 countries.

(a) The Study on COgnition and Prognosis in the Elderly

Notes

-- Takeda is a research-based global company with its main focus on pharmaceuticals. The largest pharmaceutical company in Japan and one of the leaders in the world, Takeda is committed to making a difference in people's lives by creating innovative and effective ways to alleviate disease and promote good health

-- Takeda markets its original products such as candesartan cilexetil (marketed as Blopress(R), Kenzen(R) and Amias(R)), pioglitazone hydrochloride, leuprolide acetate and lansoprazole from Japan and 14 overseas bases in the US, Europe and Asia. Including sales through licensees, Takeda's pharmaceuticals are available in over 100 countries worldwide.

References

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Geneva, 1997

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(iii) Lacourciere Y, Asmar R, for the Candesartan/Losartan study

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clinic and ambulatory blood pressure after a missed dose, in

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(viii) Kloner RA, Weinberger M, Pool JL, Chrysant SG, Prasad R,

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(ix) Belcher G, Hubner R, George M, Elmfeldt D, Lunde H.

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Note to Editors: The "(1)" in "AT(1)" is a subscript 1.