Lüders Stephan
St Josefs Hospital, Cloppenburg, Germany, s.lueders@ kh-clp.de.
J Renin Angiotensin Aldosterone Syst. 2005 Mar;6(1_suppl):S12-S15. doi: 10.1177/14703203050060010401.
The morbidity and mortality after stroke - eprosartan compared with nitrendipine for secondary prevention (MOSES) trial compared the effects of two antihypertensive agents in secondary prevention of stroke. The hypothesis of the trial was that in hypertensive stroke patients, for the same level of blood pressure (BP) control, eprosartan would be more effective than nitrendipine in reducing cerebrovascular and cardiovascular morbidity and mortality. A total of 710 patients were assigned to an eprosartan-based regimen and 695 to a nitrendipine-based regimen.These patients had hypertension requiring treatment and documented cerebral ischaemia or haemorrhage. They were well matched at baseline in general characteristics, BP and concomitant disease. BP was lowered to the same extent in both treatment arms, with a very similar timeframe. A high proportion of patients in both treatment arms achieved target BP. The combined primary endpoint was a composite of total mortality and total number of cardiovascular and cerebrovascular events, including recurrent events.There were 206 endpoints in the eprosartan group and 255 endpoints in the nitrendipine group.This represents a statistically significant 21% risk reduction in favour of eprosartan. Eprosartan also had advantages over nitrendipine in respect of all cerebrovascular events and first cardiovascular events.
卒中后发病率和死亡率——依普罗沙坦与尼群地平用于二级预防比较（MOSES）试验比较了两种抗高血压药物在卒中二级预防中的效果。该试验的假设是，在高血压卒中患者中，对于相同的血压（BP）控制水平，依普罗沙坦在降低脑血管和心血管发病率及死亡率方面比尼群地平更有效。共有710例患者被分配到以依普罗沙坦为基础的治疗方案组，695例患者被分配到以尼群地平为基础的治疗方案组。这些患者患有需要治疗的高血压且有脑缺血或出血的记录。他们在基线时的一般特征、血压和伴随疾病方面匹配良好。两个治疗组的血压均在相似的时间范围内降低到相同程度。两个治疗组中很大一部分患者达到了目标血压。联合主要终点是总死亡率与心血管和脑血管事件总数（包括复发事件）的综合指标。依普罗沙坦组有206个终点事件，尼群地平组有255个终点事件。这表明依普罗沙坦在统计学上有显著优势，风险降低了21%。在所有脑血管事件和首次心血管事件方面，依普罗沙坦也比尼群地平有优势。
