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Baseline Characteristics and Early Blood Pressure Control in the CONVINCE Trial.
MedLine Citation:
PMID:  11208750     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
-Blood pressure (BP) control rates around the world are suboptimal. Part 2 of the National Health and Nutrition Educational Survey (NHANES) III indicates that only 27.4% of hypertensive Americans aged 18 to 74 years have a BP of <140/90 mm Hg. We wanted to assess BP control during the first 2 years and to describe the baseline characteristics of patients enrolled in the Controlled ONset Verapamil INvestigation of Cardiovascular Endpoints (CONVINCE) Study, an international clinical trial that compares outcomes in hypertensive patients randomized to initial treatment with either controlled-onset extended-release verapamil or the investigator's choice of atenolol or hydrochlorothiazide. At randomization, BP was <140/90 mm Hg in only 20.3% of the 16 602 subjects (average+/-SD age 65.6+/-7.4 years; 56% women, 84% white/7% black/7% Hispanic). The average BP at enrollment was 148/85 mm Hg for patients taking BP medications (n=13 879) and 161/94 mm Hg for previously untreated patients (n=2723). After medication titration, with a transtelephonic computer that recommended an increase in the dose or number of antihypertensive agents whenever the BP was 140/90 mm Hg, 84.8% of the subjects attained the goal BP. During 2 years of treatment, BP control was maintained in 67% to 69% of the subjects (69% to 71% for systolic BP of <140 mm Hg and 90% for diastolic BP of <90 mm Hg). These data suggest that the control of systolic BP is more difficult than the control of diastolic BP. The US national goal of having 50% of hypertensives with a BP of <140/90 mm Hg may be achievable if a forced titration strategy is used. Interested investigators, free care and medications, and well-educated subjects may make the attainment of such a goal easier in the CONVINCE study than in the general population.
Authors:
Henry R. Black; William J. Elliott; James D. Neaton; Gregory Grandits; Patricia Grambsch; Richard H. Grimm; Lennart Hansson; Yves Lacoucière; James Muller; Peter Sleight; Michael A. Weber; William B. White; Gordon Williams; Janet Wittes; Alberto Zanchetti; T. Daniel Fakouhi; Robert J. Anders
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Hypertension     Volume:  37     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-Feb-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  -    
Other Details:
Languages:  ENG     Pagination:  12-18     Citation Subset:  -    
Affiliation:
Department of Preventive Medicine (H.R.B., W.J.E.), Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill.
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