Drug combinations involving statins, aspirin, and beta-blockers improve the survival of people with Heart disease involving ischemia - restriction of blood flow through the coronary arteries - according to UK doctors.

Adding an ACE inhibitor to this mix, however, does not provide further benefit.

“Our study is the first large scale, long-term community based study to report the effect of different combinations of drugs in the secondary prevention of all-cause mortality in patients with Ischemic heart disease,” Dr. Julia Hippisley-Cox and Dr. Carol Coupland, from the University of Nottingham, note in the British Medical Journal.

The study involved 11,330 patients with heart disease who were drawn from a general practice registry in the UK. The analysis compared the use of various combinations of drugs by 2266 patients who died and 9064 matched “controls” who survived.

Combinations of statins, aspirin, and beta-blockers led to the greatest reduction in mortality from all causes - 83 percent. As noted, the addition of an ACE inhibitor did not significantly affect the reduction. If, however, ACE inhibitors were substituted for beta-blockers, the reduction in mortality fell to 71 percent.

Beta-blockers and ACE inhibitors taken alone provided the smallest reduction in mortality - around 20 percent for each. Also, the reduction seen when statins and ACE inhibitors were used together was not much better - 31 percent.

SOURCE: British Medical Journal, May 7, 2005.