[Prevention of cardiovascular events by the antihypertensive treatment using amlodipine and perindopril in comparison with the use of atenolol and bendroflumethiazide. The ASCOT (Anglo-Scandinavian Outcomes Trail: blood pressure lowering arm) study results--multicentre, randomised, controlled trial. Landmark in the development of opinions on combination therapy in hypertension? (comment)].
It is a multicentre, prospective, randomised controlled trial in 19 257 patients with hypertension aged 40-79 years with at least three cardiovascular risk factors. After 5,5 years median follow-up fewer individuals on amlodipine + perindopril had a primary endpoint (429 vs 474, HR 0.90, p = 0.1052), fatal and non-fatal stoke (327 vs 422, HR 0.77, p = 0.0003), total cardiovascular events and procedures 1362 vs 1602, 0.84, p = 0.0001) and all cause mortality (738 vs. 820, HR 0.89, p = 0.025). The incidence of developing diabetes was also less on the amlodipine + perindopril based regimen (567 vs 799, HR 0,70, p = 0.0001). The amlodipine-perindopril based regiment prevented more major cardiovascular events and induced less diabetes than the atenolol-based regimen. These results may have in implications with respect to optimum combinations of antihypertensive drugs.
Widimský
J
J
Centrum pro hypertenzi, vedoucí, interní kliniky 1. lékarské fakulty UK a VFN, Praha. jiri.widimsky@lf1.cuni.cz
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
D000959:Antihypertensive Agents