Target Blood Pressure for Treatment of Isolated Systolic Hypertension in the Elderly Valsartan in Elderly Isolated Systolic Hypertension Study
Target Blood Pressure for Treatment of Isolated Systolic Hypertension in the Elderly Valsartan in Elderly Isolated Systolic Hypertension Study
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DOI：
10.1161/hypertensionaha.109.146035
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发表时间：
2010-08-01
期刊：
影响因子：
8.3
通讯作者：
Ueshima, Hirotsugu
中科院分区：
文献类型：
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作者：
Ogihara, Toshio;Saruta, Takao;Ueshima, Hirotsugu
在这项前瞻性、随机、开放标签、盲法终点研究中，我们旨在确定在降低老年孤立性收缩期高血压患者心血管死亡率和发病率方面，严格血压控制（< 140 mm Hg）是否优于中度血压控制（>= 140 mm Hg至< 150 mm Hg）。我们将3260例70 ~ 84岁的孤立性收缩期高血压（坐位血压160 ~ 199 mm Hg）患者按严格或中度降压治疗分为两组。评估>= 2年期间心血管事件的综合情况。严格对照组（1545例）和中度对照组（1534例）匹配良好（平均年龄：76.1岁，平均血压：169.5/81.5 mm Hg）。中位随访时间为3.07年。3年时，血压分别达到136.6/74.8 mm Hg和142.0/76.5 mm Hg。两组血压差值为5.4/1.7 mm Hg。严格对照组主要复合终点发生率为10.6 / 1000患者-年，中度对照组为12.0 / 1000患者-年（风险比：0.89;[95% CI: 0.60 ~ 1.34]； P=0.38）。总之，血压目标为70岁孤立性收缩期高血压，尽管我们的试验不足以明确确定严格控制是否优于不太严格的血压目标。（高血压，2010;56:196-202）
In this prospective, randomized, open-label, blinded end point study, we aimed to establish whether strict blood pressure control (< 140 mm Hg) is superior to moderate blood pressure control (>= 140 mm Hg to < 150 mm Hg) in reducing cardiovascular mortality and morbidity in elderly patients with isolated systolic hypertension. We divided 3260 patients aged 70 to 84 years with isolated systolic hypertension (sitting blood pressure 160 to 199 mm Hg) into 2 groups, according to strict or moderate blood pressure treatment. A composite of cardiovascular events was evaluated for >= 2 years. The strict control (1545 patients) and moderate control (1534 patients) groups were well matched (mean age: 76.1 years; mean blood pressure: 169.5/81.5 mm Hg). Median follow-up was 3.07 years. At 3 years, blood pressure reached 136.6/74.8 mm Hg and 142.0/76.5 mm Hg, respectively. The blood pressure difference between the 2 groups was 5.4/1.7 mm Hg. The overall rate of the primary composite end point was 10.6 per 1000 patient-years in the strict control group and 12.0 per 1000 patient-years in the moderate control group (hazard ratio: 0.89; [95% CI: 0.60 to 1.34]; P=0.38). In summary, blood pressure targets of = 70 years of age with isolated systolic hypertension, although our trial was underpowered to definitively determine whether strict control was superior to less stringent blood pressure targets. (Hypertension. 2010; 56:196-202.)