CV events reduced with more intense treatment in high risk patients
The INTEROUT study presented by Dr. Zhi-Min Hin from Shanghai showed again that in high-risk Chinese patients more intensified antihypertensive treatment reduces cardiovascular (CV) morbidity and mortality. The FEVER trial, also presented at the 15th European Meeting on Hypertension, showed that the addition of felodopine in patients, significantly reduced CV events and cancer.
Intensified therapy, compared to routine therapy, reduced the primary endpoint by 78% (p<0.0001), total mortality by 64% (p<0.0001), and stroke (fatal and nonfatal) by 72% (p<0.001). The primary endpoint was the composite of stroke (fatal and nonfatal), MI (fatal and nonfatal), and other CV death.
At 4.5 years, SBP was 132 mmHg in the intensified group and 150 mmHg in the routine therapy group, and DBP was less than 90 mmHg in both groups.
There were 381 patients in the routine therapy group and 382 in the intensified treatment group. The mean age was 65 years, BMI 24, SBP 175 mmHg, DBP 98 mmHg. Eleven percent of the routine group and 9% of the intensified group had a previous stroke. Intensified treatment was initiated with either ACE inhibitor, beta-blocker, CCB, or a diuretic, and then drugs added from other classes as needed to lower BP to <140/90 mmHg.

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