BloodPressure.pptVIP

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2016-01-04 发布于四川
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BloodPressure.ppt

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BloodPressure.ppt

The Anglo-Scandinavian Cardiac Outcomes Trial –Blood Pressure Lowering Arm (ASCOT-BPLA) Blood Pressure Variability and Cardiovascular Outcomes PS Sever, PM Rothwell, SC Howard, JE Dobson, B Dahl?f, H Wedel, NR Poulter, for the ASCOT Investigators International Centre for Circulatory Health, Imperial College London and Stroke Prevention Research Unit, University of Oxford A randomised controlled trial of the prevention of CHD and other vascular events by BP and cholesterol lowering in a factorial study design Study design atenolol ± bendroflumethiazide amlodipine ± perindopril 19,257 hypertensive patients PROBE design ASCOT-BPLA Stopped after 5.5 yrs Investigator-led, multinational randomised controlled trial conducted in hypertensive patients, 40 -79 yrs, with no prior history of CHD, but with 3 additional cardiovascular risk factors (male sex, 55 yrs, smoking etc ) Treatment algorithm to BP targets 140/90 mmHg or 130/80 mmHg in patients with diabetes amlodipine 5-10 mg atenolol 50-100 mg perindopril 4-8 mg bendroflumethiazide-K 1.25-2.5 mg doxazosin GITS 4-8 mg add add add additional drugs, eg, moxonidine/spironolactone add Median follow up was for 5.5 years Baseline characteristics Amlodipine ± perindopriln = 9639 Atenolol ± thiaziden = 9618 Demographic and clinical characteristics Male 7381 (76.6%) 7361 (76.5%) White 9187 (95.3%) 9170 (95.3%) Current smoker 3168 (32.9%) 3110 (32.3%) Age (years) 63.0 (8.5) 63.0 (8.5) SBP (mmHg) 164.1 (18.1) 163.9 (18.0) DBP (mmHg) 94.8 (10.4) 94.5 (10.4) Heart rate (bpm) 71.9 (12.7) 71.8 (12.6) BMI (kg/m2) 28.7 (4.6) 28.7 (4.5) Diabetes 2567 (27%) 2578 (27%) Other vascular disease 2169 (23%) 2162 (22%) Total cholesterol (mmol/L) 5.9 (1.1) 5.9 (1.1) Drug therapy Previous antihypertensive treatments 1841 (19.1%) 1825 (19.0%) 0 1 4280 (44.4%) 4283 (44.5%) ≥2 3518 (36.5%) 3510 (36.5%) Lipid-lowering therapy 1046 (10.9%) 1004 (10.4%) Aspirin 1851 (19.2%) 1837 (19.1%) Values are number of patients (%), or mea