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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EThe MILLION study shows that aggressive, simultaneous treatment with an amlodipine- and statin-based regimen lowers blood pressure and low-density lipoprotein cholesterol to a greater extent than standard intensity treatment in a Japanese population. However, percent change in coronary plaque volume, and lumen and vessel volume were similar among both treatment arms.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Estatin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eamlodipine\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eblood pressure\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eplaque\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecoronary artery disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Elow-density lipoprotein cholesterol\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ELDL-C\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiology \u0026amp; cardiovascular medicine clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EAn aggressive, simultaneous amlodipine- and statin-based regimen significantly decreased blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) compared with a standard-intensity regimen in a Japanese population with coronary artery disease (CAD). Masa-aki Kawashiri, MD, Kanazawa University, Kanazawa, Japan, presented these unpublished data from the MILLION study.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EIntensive statin therapy for lowering LDL-C had been demonstrated to reduce the risk of major adverse cardiovascular events compared with moderate-intensity statin therapy. In addition, lowering BP with an amlodipine-based regimen also reduced major adverse cardiovascular events in patients with hypertension compared with a \u03b2-blocker or angiotensin-converting enzyme inhibitor\u2013based regimen. However, the combination of both LDL-C and BP lowering did not affect outcomes compared with standard therapy [Kohro T et al. \u003Cem\u003ECirc J\u003C\/em\u003E. 2011]. The purpose of the MILLION trial was to evaluate the change in plaque volume using intravascular ultrasonography, BP, and lipids in a Japanese population with CAD.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn the open-label, multicenter MILLION study, 100 patients with CAD who underwent percutaneous coronary intervention were randomly assigned to receive standard therapy with amlodipine 2.5 mg and atorvastatin 5 mg and other agents as necessary to reduce BP to \u0026lt;\u2005140\/90 mm Hg and LDL-C to \u0026lt;\u2005100 mg\/dL, or aggressive treatment with amlodipine 5 mg and atorvastatin 10 mg and other agents to decrease BP to \u0026lt;\u2005120\/70 mm Hg and LDL-C to \u0026lt;\u200570 mg\/dL [Kawashiri MA et al. \u003Cem\u003EHeart Vessels\u003C\/em\u003E. 2014]. Patients were excluded if the percutaneous coronary intervention was unsuccessful, they had type 1 diabetes or poorly controlled diabetes, they were receiving insulin therapy, had secondary hypertension, were using dihydropyridine calcium channel antagonist for \u0026gt;\u20056 months, used an intensive lipid-lowering statin agent, had familial hypercholesterolemia, or were aged \u2265\u200580 years. Baseline characteristics were similar between the 2 arms.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAmong the 68 patients who completed the study, the primary end point of this study, the percent change in coronary plaque volume, decreased in the standard treatment arm (n\u2005=\u200533; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.006) and the aggressive treatment arm (n\u2005=\u200535; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.008), but there were no differences between the 2 therapies. In addition, BP and LDL-C were significantly reduced in both arms, with a greater reduction in the aggressive treatment arm compared with the standard treatment arm (BP, \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.0009; LDL-C, \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.007; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). There was no significant difference in percent change in lumen and vessel volume between the 2 arms.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/10\/7\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Effect of Aggressive Therapy for BP and LDL-C LoweringBP, blood pressure; LDL-C, low-density lipoprotein cholesterol.*Paired t-test.**Unpaired t-test.Reproduced with permission from M Kawashiri, MD.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-875604420\u0022 data-figure-caption=\u0022\u0026amp;lt;div xmlns=\u0026amp;quot;http:\/\/www.w3.org\/1999\/xhtml\u0026amp;quot;\u0026amp;gt;Effect of Aggressive Therapy for BP and LDL-C LoweringBP, blood pressure; LDL-C, low-density lipoprotein cholesterol.\u0026amp;lt;sup\u0026amp;gt;*\u0026amp;lt;\/sup\u0026amp;gt;Paired t-test.\u0026amp;lt;sup\u0026amp;gt;**\u0026amp;lt;\/sup\u0026amp;gt;Unpaired t-test.Reproduced with permission from M Kawashiri, MD.\u0026amp;lt;\/div\u0026amp;gt;\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/10\/7\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/10\/7\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/15\/10\/7\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16674\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EEffect of Aggressive Therapy for BP and LDL-C Lowering\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EBP, blood pressure; LDL-C, low-density lipoprotein cholesterol.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003E\u003Csup\u003E*\u003C\/sup\u003EPaired t-test.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003E\u003Csup\u003E**\u003C\/sup\u003EUnpaired t-test.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EReproduced with permission from M Kawashiri, MD.\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-11\u0022\u003EDr Kawashiri concluded that the data from the MILLION trial suggest that both standard and aggressive BP and lipid-lowering regimens were effective; however, a greater decrease in BP and LDL-C was evident in the aggressive treatment group compared with standard therapy.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/10\/7.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzll01\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzll01\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}