STOP-Hypertension 2: a prospective intervention trial of "newer" versus "older" treatment alternatives in old patients with hypertension. Swedish Trial in Old Patients with Hypertension.
STOP-Hypertension 2: a prospective intervention trial of "newer" versus "older" treatment alternatives in old patients with hypertension. Swedish Trial in Old Patients with Hypertension.
复制标题
STOP-Hypertension 2：一项针对老年高血压患者的“新”与“旧”治疗方案的前瞻性干预试验。
作者：
B. Dahlöf;L. Hansson;L. Lindholm;Bengt Scherstén;P.;T. Ekbom;T. Hedner;U. Faire
众所周知，高血压患者受益于其疾病的药物治疗。近年来，三项关于老年高血压患者抗高血压治疗的主要结局研究显示了显著的益处，即降低了卒中和其他心血管死亡率和发病率的风险。在所有这些研究中，与安慰剂相比，使用β受体阻滞剂和/或利尿剂。然而，至少在理论上，较新的治疗方法具有许多优点，可能导致预后的进一步改善。瑞典针对老年高血压患者的初步试验（STOP-Hypertension 1）是在70-84岁的男性和女性中进行的。STOP-高血压2将使用PROBE设计（前瞻性、随机化、开放性、设盲终点评价）评价STOP-高血压1中使用的治疗与基于ACE抑制剂（依那普利和赖诺普利）或钙拮抗剂（伊拉地平和非洛地平）的治疗。主要目的是评估对心血管死亡率的影响。统计学计算表明，如果新疗法和已确立疗法之间存在25%的差异，则需要对6，600名患者进行4年随访（2 p < 0.05，把握度90%）才能获得显著性。如果患者的仰卧位血压>或= 180/105 mmHg（和/或），则将纳入初级卫生保健（300个中心）。1992年9月开始招募患者，迄今每周已纳入100多名患者。
It is well established that hypertensive patients benefit from drug treatment of their disorder. In recent years three major out-come studies of antihypertensive treatment in elderly hypertensives have shown substantial benefits, i.e. a reduction in the risk of stroke and other cardiovascular mortality and morbidity. In all these studies beta-blockers and/or diuretics were used in comparison with placebo. Newer therapeutic alternatives have, however, at least theoretically, many advantages which could result in further improvements in prognosis. The initial Swedish Trial in Old Patients with Hypertension (STOP-Hypertension 1) was conducted in men and women aged 70-84 years. STOP-Hypertension 2 will evaluate the therapy used in STOP-Hypertension 1 against therapy based on either ACE-inhibitors (enalapril and lisinopril) or on calcium antagonists (isradipine and felodipine), using the PROBE design (Prospective, Randomised, Open, Blinded Endpoint evaluation). The primary aim will be to assess the effect on cardiovascular mortality. Statistical calculations indicate that 6,600 patients, followed for four years will be needed (2p < 0.05, power 90%) to obtain significance if there is a 25% difference between the new and the established therapy. Patients in primary health care (300 centres) will be included if their supine blood pressure is > or = 180/105 mmHg (and/or). Recruitment of patients started in September 1992 and so far more than 100 patients/week have been included.