SUBGROUP ANALYSIS
ACTION subgroup analysis: Nifedipine GITS more beneficial in hypertensive patients with CAD
Prof. P. Poole-Wilson, UK |
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Some outcomes in the ACTION trial were affected by the level of blood pressure at study entry (above or below 140/90 mm Hg) [video clip 1]. Prof. Philip Poole-Wilson (ImperialCollege in London, UK) presented a subgroup analysis of this interaction at the 15th European Meeting of Hypertension, held June 17 to 21, 2005 in Milan, Italy. In the main study, a blood pressure below 140/90 mm Hg significantly favored nifedipine versus placebo for the primary endpoint (p=0.02).
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Clinical Trials
Non-CV mortality increased with DBP below 70 mm Hg in Syst-Eur analysis
Dr. R. Fagard,
Belgium |
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In elderly patients (average age 70 years) a diastolic blood pressure DBP) less than 70 mm Hg was associated with increased non-cardiovascular (CV) mortality, while a DBP less than 50 mm Hg did not increase CV morbidity and mortality.
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Clinical Trials
ALLHAT: Differential effects for amlodipine compared to lisinopril
Dr. W. Cushman,
USA |
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Amlodipine was associated with less stroke, combined CVD, GI bleed, angina, and peripheral arterial disease (PAD), compared to lisinopril, in a comparison of the
9048 patients in ALLHAT who were randomized to amlodipine (2.5 to 10 mg) and the 9054 patients randomized to lisinopril (10-40 mg).
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Cardiovascular Risk Factors
Changes in renal function seen with increasingly elevated blood pressures
A total of 25% of patients with hypertension and 33% with hypertension and diabetes had microalbuminuria (MAB) and elevated urinary albumin excretion (UAE), of a total of 7673 patients receiving care in a primary care setting in Spain.
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pre-specified analysis
VALUE: Valsartan compared to amlodipine reduces new-onset diabetes in high-risk hypertensive patients
Dr. S. Kjeldsen,
Norway |
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Valsartan was associated with a significant reduction in new-onset diabetes compared to amlodipine in a further pre-specified analysis of the VALUE trial, presented by Dr. Sverre Kjeldsen (Oslo, Norway) at the 15th European Meeting of Hypertension, held in Milan from June 17-21, 2005.
With valsartan there were 580 new cases of diabetes (11.5%) and with amlodipine there were 718 new cases (14.5%) reported (p<0.0001). The number of patients needed to treat to prevent 1 case of new onset diabetes was only 33.
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Clinical Trials
PERFECT: Perindopril improves endothelial function, may explain EUROPA results
A well-powered study of 333 patients in 20 centers compared the effect of perindopril 8 mg once daily and a matching placebo on flow-mediated vasodilation (FMD) at 36 months as a measure of endothelial function in the brachial artery of patients with stable coronary artery disease and no clinical heart failure.
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Clinical Trials
Plaque number at baseline predictive of events in the ELSA study
Prof. A. Zanchetti, Italy
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A new analysis of the ELSA study has shown that the number of plaques at baseline predicted cardiovascular events, with a significant increase in the number of most events with an increase in the number of plaques. Although changes in the intima-media thickness (IMT) were associated with some events, the baseline number of plaques was a more powerful predictor.
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