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Göteborgs universitets publikationer

Exceptional early blood pressure control rates: the ACCOMPLISH trial

Författare och institution:
K. Jamerson (-); G. L. Bakris (-); Björn Dahlöf (Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin); B. Pitt (-); E. Velazquez (-); J. Gupte (-); M. Lefkowitz (-); A. Hester (-); V. Shi (-); S. E. Kjeldsen (-); W. Cushman (-); V. Papademetriou (-); M. Weber (-)
Publicerad i:
Blood Press, 16 ( 2 ) s. 80-6
0803-7051 (Print)
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
BACKGROUND: ACCOMPLISH is a "new-generation" hypertension trial assessing single-tablet combination therapy for initial treatment of high-risk hypertension. At baseline, 97% of subjects were treated with anti-hypertensive medication at entry, but only 37% of participants had blood pressure (BP) control (<140/90 mmHg). Single-tablet combination therapy may improve control rates. METHODS: The mean BP change from baseline at the end of 6 months (the time point when subjects should have had all of the drug titrations to achieve BP control) was examined for 10,704 randomized patients. Within-group changes were examined using t-tests. Comparisons between subgroups were made using analysis of variance (ANOVA) and covariance (ANCOVA). RESULTS: Mean (+/-SD) BP fell from 145+/-18/80+/-11 mmHg at randomization to 132+/-16/74+/-10 mmHg. The 6-month BP control rate was 73% in the overall trial (78% in the US), 43% in diabetics and 40% in patients with renal disease. Of the patients uncontrolled, 61% were not on maximal medications, suggesting potential increases in control rates. Serious hypotensive events occurred in 1.8% of participants. CONCLUSION: ACCOMPLISH BP control rates are the highest of any multi-national trial to date. Whereas current guidelines recommend combination therapy only for stage 2 hypertension, in this trial it is expedient and safe for both stage 1 and 2 hypertension.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Amlodipine/administration & dosage, Antihypertensive Agents/*administration & dosage/adverse effects, Benzazepines/administration & dosage, Blood Pressure/drug effects, Double-Blind Method, Drug Therapy, Combination, Humans, Hydrochlorothiazide/administration & dosage, Hypertension/*drug therapy/physiopathology
Postens nummer:
Posten skapad:
2007-10-19 15:18
Posten ändrad:
2007-11-05 15:50

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