title: [Modeling of systolic blood pressure reaction to antihypertensive agents in people with hypertension].
abstract: OBJECTIVE
  We used the individual patient data from clinical trials, pooled in the INDANA data set, to explore whether blood pressure reduction was related to the baseline individual characteristics, and quantify the potential associations.
  
  
  METHODS
  We used the data from 31 140 patients with essential hypertension recruited in four randomized placebo-controlled clinical trials, MRC35-64, MRC65-74, STEP and SYST-EU. Thiazide diuretics, β-blocker, and calcium channel blocker, three of six major BP lowering drugs were analyzed. Patients were all with the same first dosage of the drug in each trial. Age, body weight, height, level of total cholesterin (TC), systolic blood pressure (SBP) and diastolic blood pressure (DBP) when initialed and at first visit of follow-up, pharmacological treatment, gender, status of smoking, history of myocardium infarction were factors taken into model. Data were managed by software SAS(®). Statistical analyses were performed with SAS(®) and R. Model was developed to evaluate the relationship between decrease of SBP and characteristics of patients.
  
  
  RESULTS
  Initial SBP is the only modifier of treatment effect on SBP response in the 3 BP lowering drug classes (β = 0.09, 0.37 and 0.18, respectively). Age and initial DBP were factors significantly correlated with SBP fall for diuretic (β = 0.17 and 0.14), and age was one of factors significantly correlated with SBP fall for β-blocker (β = -0.17). Smokers would receive less SBP fall compare to non-smokers in β-blocker active treated group (β = -2.07). There is converse effect of age between the diuretic and β-blocker; older people seem sensitive to diuretic, while young people are sensitive to β-blocker. As to calcium channel antagonist class, body weight is another modifier (β = 0.06) (All P value are 0.000 except 0.050 for body weight in calcium channel antagonist class).
  
  
  CONCLUSIONS
  We identified 5 significant modifiers (baseline SBP and DBP, age, smoking status and body weight) for SBP response to treatment effect, while gender, TC and history of myocardial infarction are not modifiers for SBP response to treatment effect.
authors.affiliation: Key Laboratory of Clinical Trial Research in Cardiovascular Drugs Ministry of Health, Cardiovascular Institute and Fu Wai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wu
authors.forename: Yi-Shi
authors.initials: YS
authors.lastname: Li
authors.forename: Theodora
authors.initials: T
authors.lastname: Bejan-Angoulvant
authors.forename: François
authors.initials: F
authors.lastname: Gueyffier
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001794:Blood Pressure; D001835:Body Weight; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D016032:Randomized Controlled Trials as Topic; D012907:Smoking; D049993:Sodium Chloride Symporter Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D013599:Systole
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D049993:Sodium Chloride Symporter Inhibitors