| Do ancillary properties of antihypertensive drugs explain the outcome results of recent trials? | |
| | |
MedLine Citation:
|
PMID: 12243374 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: In a quantitative overview of published trials, we investigated whether some pharmacological properties of antihypertensive drugs, besides reduction in blood pressure, explain cardiovascular outcomes in hypertensive or high-risk patients. METHODS: Across trials, using meta-regression, we correlated odds ratios with differences in systolic blood pressure between study groups. We then compared odds ratios of benefit observed in recent trials with those predicted by metaregression on the basis of the differences in systolic pressure between randomised groups. RESULTS: Significant differences in systolic pressure between randomised groups (experimental minus reference) were observed in the ALLHAT (-2/+1), CAPPP(-3/-1) and NORDIL (-3.1/+0.2) trials. Furthermore, the differences in achieved systolic and/or diastolic pressure between study groups were also significant in the hypertension trials which involved untreated control patients, as well as in MIDAS (-3.5/ approximately 0 mm Hg), HOPE (-3.3/-1.0 mm Hg), PART2 (-5/-4 mm Hg), and SCAT (4/-2 mm Hg) (1). The differences between the observed odds ratios and those predicted by the meta-regression between outcome and difference in systolic pressure did not reach statistical significance except for the NORDIL trial, in which the risk of stroke was lower on diltiazem than on the older drugs despite a 3.1 mm Hg higher systolic pressure on the calcium-channel blocker. CONCLUSIONS: The finding that in the reviewed trials blood pressure reduction largely accounted for outcome emphasizes the desirability of blood pressure control. The hypothesis that converting-enzyme inhibitors or alpha-blockers might influence cardiovascular prognosis over and beyond their antihypertensive effect remains unproved. |
| | |
Authors:
|
Jan A Staessen; Jiguang Wang |
Related Documents
:
|
18713094 - Comparison of severity scoring systems a-drop and curb-65 for community-acquired pneumo... 3952544 - Treatment of hypertension in the elderly. 17239684 - The use of b-type natriuretic peptide to assess volume status in patients with end-stag... 12597674 - Effects of progressive muscle relaxation on blood pressure and psychosocial status for ... 22858884 - Measuring dead-space in acute lung injury. 7681734 - Alteration of left ventricular endocardial function by intracavitary high-power ultraso... |
Publication Detail:
|
Type: Journal Article; Meta-Analysis |
Journal Detail:
|
Title: Journal of nephrology Volume: 15 ISSN: 1121-8428 ISO Abbreviation: J. Nephrol. Publication Date: 2002 Jul-Aug |
Date Detail:
|
Created Date: 2002-09-23 Completed Date: 2003-01-30 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 9012268 Medline TA: J Nephrol Country: Italy |
Other Details:
|
Languages: eng Pagination: 422-7 Citation Subset: IM |
Affiliation:
|
Study Coordinating Centre, Department of Molecular and Cardiovascular Research, University of Leuven, Belgium. jan.staessen@med.kuleuven.ac.be |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Antihypertensive Agents
/
pharmacology,
therapeutic use* Blood Pressure Determination Cardiovascular Diseases / complications, diagnosis, drug therapy*, mortality* Female Humans Hypertension / complications, diagnosis, drug therapy* Linear Models Male Odds Ratio Predictive Value of Tests Prognosis Randomized Controlled Trials as Topic Risk Assessment Risk Factors Sensitivity and Specificity Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Antihypertensive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Hyperhomocyst(e)inemia: is this a novel risk factor in hypertension?
Next Document: Inhibitors of the renin-angiotensin system reduce the rate of GFR decline and end-stage renal diseas...