Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
J Hum Hypertens. 2012 Nov;26(11):656-63. doi: 10.1038/jhh.2011.91. Epub 2011 Oct 13.
The Valsartan Amlodipine Randomized Trial (VART) was performed to compare the beneficial effects of valsartan and amlodipine on cardiovascular events in Japanese hypertensive patients. In this subanalysis of the VART, we assessed the relationship between home blood pressure (HBP) levels and cardiovascular events in the enrolled patients. We enrolled 1021 patients with mild-to-moderate hypertension in the VART. The participants were allocated randomly to either the valsartan group or the amlodipine group. The primary end point was a composite of all-cause death, sudden death, cerebrovascular events, cardiac events, vascular events and renal events. A total of 621 patients (valsartan group: 305 and amlodipine group: 316) completed the measurements of HBP (morning and evening) throughout the trial. Both the agents evenly and significantly lowered morning HBP and evening HBP throughout the trial. There was no significant difference in the primary end point between the two groups. However, we observed significant decreases in the left ventricular mass index and urinary albumin to creatinine ratio in the valsartan group but not in the amlodipine group. There were no significant differences in HBP levels and the main outcome of the cardiovascular events between the valsartan and amlodipine groups. However, in the valsartan group, significant improvements in left ventricular hypertrophy and microalbuminuria were observed.
缬沙坦氨氯地平随机试验（VART）旨在比较缬沙坦和氨氯地平对日本高血压患者心血管事件的有益影响。在 VART 的这项亚分析中，我们评估了纳入患者的家庭血压（HBP）水平与心血管事件之间的关系。我们在 VART 中纳入了 1021 例轻中度高血压患者。参与者被随机分配到缬沙坦组或氨氯地平组。主要终点是全因死亡、猝死、脑血管事件、心脏事件、血管事件和肾脏事件的综合。共有 621 名患者（缬沙坦组：305 名，氨氯地平组：316 名）完成了整个试验期间的 HBP（早晨和晚上）测量。两种药物在整个试验期间均均匀且显著降低了早晨 HBP 和晚上 HBP。两组之间主要终点无显著差异。然而，我们观察到缬沙坦组左心室质量指数和尿白蛋白与肌酐比值显著降低，但氨氯地平组没有。两组之间 HBP 水平和心血管事件的主要结局没有显著差异。然而，在缬沙坦组，观察到左心室肥厚和微量白蛋白尿的显著改善。
