基于临床试验高血压治疗策略

Trials
Year Contributions
SHEP Systolic HT in the Elderly Reduced Total Stroke and all CHD VA study on Monotherapy CDN Captopril in Type 1 Diabetic Nephropathy
2001
• Large simple trials of treatment of a chronic disease • Clinical practice • Technological progress
Trials
Year Contributions
LIFE
Losartan Intervention for endpoint Reduction in HT
Trials
STOP-HT-2 Swedish Trial in Old Pts. With HT
PROGRESS Perindopril Protection Against Recurrent Stroke Study
CONVINCE Controlled Onset Verapamil Investigation for CVD Endpoints
1984
MRC ELDERLY TRIAL Medical Research Council Trial of Treatment of HT in Older Adults
STOP-HT The Swedish Trial in Old Pats. with HT
1987 1991
CHD could be reduced in POST-MI pts. by -blocker
HOT
1997
HT Optimal Treatment Trial
Combined lifestyle/drug intervention in stage I HT is beneficial
BP reduction in post stroke pts. is beneficial, even in normotensive
Elderly HT pts. would benefit from anti HT treatment
demonstrated a significant reduction in stroke, cardiac and all CVD events
Drug treatment in HT pts. 70-84 reduce CVD morbidity & mortality & total mortality
Year
Contributions
1998 Older & newer agents are effective in treating elderly HT pts.
2000
BP reduction in post stroke pts. treated by Perindopril based treatment reduced stroke recurrence, even in normotensive
Hypertension Treatment Strategy Based on Clinical Trials
Liu Lisheng
Trials
Year Contributions
BHAT
- blocker Heart Attack Trial
1981
EWPHEຫໍສະໝຸດ Baidu
The European working Party on High BP in the Elderly
• Captopril can reduce progression of renal disease
• improved survival • Doubling of Serum Cr. Endpoint
Total mortality, CVD mortality & Stroke mortality reduced by CCB based treatment
2001
ALLHAT
2002
Antihypertensive therapy
and lipid-lowering heart
attack prevention trial
ANBP2
2002
Australian National BP Study 2
Losartan vs Atendol, primary composite endpoints
Syst.-China Chnese Systolic HT in the Elderly Trial
1991 Systolic HT in the elderly, ISH should be treated in older pts.
1990 1992
1992
HCHZ greatly enhanced the efficacy of non-diuretic drugs, HCTZ 12.5mg
pts. • Goal tolerability of anti HT
therapy • No risk in “normalizing” BP • Intensive BP lowering in DM HT pts.
(130/80) • Benefits of antiplatelet agents
Trials
Year
Contributions
TOMHS Study
The Treatment of Mild HT Study
PATs
Post Stroke Anti HT Treatment Study
Syst.-Eur.
Syst.-Eur. Multicentre Trial
1993 1993 1997
• New antihypertensive drugs • Prognosis of ISH, DM & dementia • ABP is a significant predictor of
outcome • BP to goal is possible • Comb. therapy was necessary in 70%