Goudev Assen, Berrou Jean-Pascal, Pathak Atul
Department of Cardiology, Queen Giovanna University Hospital, Sofia, Bulgaria;
Vasc Health Risk Manag. 2012;8:563-8. doi: 10.2147/VHRM.S34834. Epub 2012 Sep 25.
Estimation of total cardiovascular risk is useful for developing preventive strategies for individual patients. The POWER (Physicians' Observational Work on Patient Education According to their Vascular Risk) survey, a 6-month, open-label, multinational, post-marketing observational evaluation of eprosartan, an angiotensin II receptor blocker, was undertaken to assess the efficacy and safety of eprosartan-based therapy in the treatment of high arterial blood pressure in a large population recruited from 16 countries with varying degrees of baseline cardiovascular risk, and the effect of eprosartan-based therapy on total cardiovascular risk, as represented by the SCORE (Systematic Coronary Risk Assessment) or Framingham risk equations.
Participating physicians recruited > 29,000 hypertensive patients whom they considered to be candidates (according to specified criteria) for treatment with eprosartan 600 mg/day, with other drugs added at the discretion of the physician.
During treatment, systolic blood pressure decreased by 25.8 ± 14.4 mmHg to 134.6 ± 11.4 mmHg (P < 0.001), mean diastolic blood pressure fell by 12.6 ± 9.5 mmHg to 81.1 ± 7.6 mmHg, and pulse pressure fell by 13.2 ± 13.5 mmHg to 53.6 ± 11.4 mmHg (both P < 0.01). Calculated total cardiovascular risk declined in parallel with the reduction in blood pressure.
The POWER study has demonstrated, in a large and nonselected population, the feasibility and practicability of reducing total cardiovascular risk through systematic management of high blood pressure.
评估总体心血管风险对于制定个体患者的预防策略很有用。进行了POWER（医生根据患者血管风险开展的患者教育观察研究）调查，这是一项为期6个月的开放标签、多国、上市后观察性评估，对象为血管紧张素II受体阻滞剂依普罗沙坦，目的是在从16个国家招募的、具有不同程度基线心血管风险的大量人群中，评估以依普罗沙坦为基础的治疗在治疗高动脉血压方面的疗效和安全性，以及以依普罗沙坦为基础的治疗对由SCORE（系统性冠状动脉风险评估）或弗雷明汉风险方程表示的总体心血管风险的影响。
参与研究的医生招募了超过29000名高血压患者，他们认为这些患者（根据特定标准）是每日服用600毫克依普罗沙坦治疗的候选者，其他药物由医生酌情添加。
治疗期间，收缩压从25.8±14.4毫米汞柱降至134.6±11.4毫米汞柱（P<0.001），平均舒张压从12.6±9.5毫米汞柱降至81.1±7.6毫米汞柱，脉压从13.2±13.5毫米汞柱降至53.6±11.4毫米汞柱（均P<0.01）。计算得出的总体心血管风险与血压降低同步下降。
POWER研究在一个大型非选择性人群中证明了通过系统管理高血压来降低总体心血管风险的可行性和实用性。
