Department of Pharmacology and Molecular Therapeutics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, 860-8556, Japan.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Sci Rep. 2020 Oct 12;10(1):17040. doi: 10.1038/s41598-020-73905-4.
To test our hypothesis that the magnitude of reduction in hsCRP achieved by antihypertensive medications may predict the benefit for cardiovascular outcomes in hypertensive individuals, we performed subanalysis of the ATTEMPT-CVD study. The hypertensive participants enrolled in the ATTMEPT-CVD study were categorized into two groups according to whether achieved reduction in hsCRP levels at 6 months after initiation of antihypertensive medications from baseline was equal to or greater than 40% (responder group) or less than 40% (non-responder group). Baseline characteristics and blood pressure during follow-up period were similar between the groups. For women, the incidence of cardiovascular events was significantly less in responder group than non-responder group (P < 0.0221). However, for men, there was no significant difference between the groups regarding incident cardiovascular events (P = 0.2434). There was a significant interaction (P = 0.0187) between sexes for incident cardiovascular events. Our results provide the evidence suggesting that substantial reduction (40% or greater reduction) in hsCRP on antihypertensive medication predicts the benefit for cardiovascular outcomes in hypertensive women but it does not in hypertensive men. The magnitude of achieved reduction in hsCRP by antihypertensive medications seems to be a useful indicator of successful treatment in Japanese hypertensive women.This trial was registered with ClinicalTrials.gov, number NCT01075698.
为了验证我们的假设,即降压药物降低 hsCRP 的幅度可以预测高血压患者心血管结局的获益,我们对 ATTEMPT-CVD 研究进行了亚组分析。ATTMEPT-CVD 研究中纳入的高血压参与者根据 6 个月后降压药物治疗起始时 hsCRP 水平从基线的降低幅度是否等于或大于 40%(应答组)或小于 40%(无应答组)分为两组。两组之间的基线特征和随访期间的血压相似。对于女性,应答组心血管事件的发生率明显低于无应答组(P < 0.0221)。然而,对于男性,两组之间心血管事件的发生率没有显著差异(P = 0.2434)。心血管事件的发生率存在显著的性别交互作用(P = 0.0187)。我们的结果提供了证据表明,降压药物治疗后 hsCRP 显著降低(降低 40%或以上)可以预测高血压女性的心血管结局获益,但不能预测高血压男性的获益。降压药物治疗后 hsCRP 降低的幅度似乎是日本高血压女性成功治疗的有用指标。这项试验在 ClinicalTrials.gov 上注册,编号为 NCT01075698。