Teramoto Tamio, Fujita Toshiro, Kawamori Ryuzo, Miyazaki Shigeru, Teramukai Satoshi, Igarashi Masao
Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashiku, Tokyo 173-8605, Japan.
Hypertens Res. 2008 Nov;31(11):2011-7. doi: 10.1291/hypres.31.2011.
Elevated systolic blood pressure increases the risk of cardiovascular events, as shown by a number of meta-analyses of large-scale clinical trials. As concerns the prognostic impact of the metabolic syndrome on cardiovascular events, few large-scale studies are available in the Japanese hypertensive population. The prospective, large-scale, observational OMEGA (Olmesartan Mega Study to Determine the Relationship between Cardiovascular Endpoints and Blood Pressure Goal Achievement) study sought to examine the relationship between the incidence of cardiovascular disease (CVD) and achieved blood pressure, metabolic syndrome, lifestyle factors and other risk factors for CVD in patients with hypertension. Of the 15,313 enrolled patients from 2,219 institutions in Japan, we report here the baseline characteristics of the 14,841 eligible patients whose baseline data were collected as of October 31, 2007. Men and women 50 to 79 years old (mean age 65) with physician-diagnosed hypertension were enrolled, and all patients were treated with open-label olmesartan medoxomil (5 to 40 mg daily). The majority of patients (75%) had mild to moderate hypertension. The prevalences of dyslipidemia and diabetes mellitus were 48% and 24%, respectively. The metabolic syndrome was identified in 48% and 19% of the evaluable men and women, respectively, using the criteria of the Japanese Society of Internal Medicine. Men with the metabolic syndrome were at the greatest risk for CVD, and a greater proportion of men than of women had all five metabolic syndrome components. The complete follow-up data from the OMEGA study will provide much-needed information to guide treatment in patients with hypertension and the metabolic syndrome. (Hypertens Res 2008; 31: 2011-2017).
多项大规模临床试验的荟萃分析表明,收缩压升高会增加心血管事件的风险。关于代谢综合征对心血管事件的预后影响,在日本高血压人群中几乎没有大规模研究。前瞻性、大规模、观察性的OMEGA(奥美沙坦大型研究以确定心血管终点与血压目标达成之间的关系)研究旨在探讨高血压患者心血管疾病(CVD)发病率与血压达标情况、代谢综合征、生活方式因素及其他CVD危险因素之间的关系。在日本2219家机构登记的15313例患者中,我们在此报告截至2007年10月31日收集了基线数据的14841例符合条件患者的基线特征。纳入了年龄在50至79岁(平均年龄65岁)、经医生诊断为高血压的男性和女性,所有患者均接受开放标签的奥美沙坦酯治疗(每日5至40毫克)。大多数患者(75%)患有轻度至中度高血压。血脂异常和糖尿病的患病率分别为48%和24%。根据日本内科医学会的标准,分别有48%的可评估男性和19%的可评估女性被诊断为代谢综合征。患有代谢综合征的男性发生CVD的风险最高,且具有所有五项代谢综合征成分的男性比例高于女性。OMEGA研究的完整随访数据将为指导高血压和代谢综合征患者的治疗提供急需的信息。(《高血压研究》2008年;31: 2011 - 2017)