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与使用阿替洛尔和苄氟噻嗪相比,氨氯地平和培哚普利联合降压治疗预防心血管事件的效果。ASCOT(盎格鲁-斯堪的纳维亚心脏结局试验:降压分支)研究结果——多中心、随机、对照试验。高血压联合治疗观点发展的里程碑?(评论)

[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)].

作者信息

Widimský J

机构信息

Centrum pro hypertenzi, vedoucí, interní kliniky 1. lékarské fakulty UK a VFN, Praha.

出版信息

Vnitr Lek. 2005 Dec;51(12):1394-6, 1398-9.

Abstract

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.

摘要

这是一项针对19257名年龄在40 - 79岁、至少有三种心血管危险因素的高血压患者的多中心、前瞻性、随机对照试验。经过5.5年的中位随访,服用氨氯地平+培哚普利的患者中发生主要终点事件的个体较少(429例对474例,风险比0.90,p = 0.1052),致命和非致命性卒中(327例对422例,风险比0.77,p = 0.0003),总的心血管事件和治疗措施(1362例对1602例,0.84,p = 0.0001)以及全因死亡率(738例对820例,风险比0.89,p = 0.025)。基于氨氯地平+培哚普利方案发生糖尿病的发生率也较低(567例对799例,风险比0.70,p = 0.0001)。与基于阿替洛尔的方案相比,基于氨氯地平 - 培哚普利的方案预防了更多的主要心血管事件,且诱发糖尿病的情况更少。这些结果可能对降压药物的最佳组合有影响。

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