Mixed models showed no need for initial response monitoring after starting antihypertensive therapy
Mixed models showed no need for initial response monitoring after starting antihypertensive therapy
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DOI：
10.1016/j.jclinepi.2008.07.018
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发表时间：
2009-06-01
影响因子：
7.2
通讯作者：
Irwig, Les
中科院分区：
文献类型：
--
作者：
Bell, Katy J. L.;Hayen, Andrew;Irwig, Les
目的：证明如何使用混合模型来估计治疗效果，并就监测初始反应的需要为决策提供信息。研究设计和设置：使用混合模型来分析培哚普利预防复发性中风研究 (PROGRESS) 的数据。该研究检查了培哚普利和吲达帕胺对 6 105 名脑血管事件高危患者的作用。结果：培哚普利的平均作用是将血压 (BP)（收缩压/舒张压）降低 6/3 mmHg。培哚普利/吲达帕胺的平均效果根据基线血压而变化，血压降低范围为 9/5 至 14/5 mmHg（对于基线收缩压分别为 140 和 > 150 mmHg 的个体）。我们发现单独使用培哚普利或与吲达帕胺联合治疗对血压的影响没有变化。治疗对个体的影响可以根据治疗组（培哚普利）或基线收缩压亚组（培哚普利/吲达帕胺）的平均效果来预测。 结论：对于与本研究中检查的类似的抗高血压药物，没有必要监测初始治疗反应。为了解决其他疗法的这个问题，我们建议试验应该报告混合模型的治疗效果估计，并且 CONSORT 声明应该扩展以包括该项目。(C) 2009 Elsevier Inc. 保留所有权利。
Objective: To demonstrate how mixed models may be used to estimate treatment effects, and inform decision, on the need for monitoring initial response.Study Design and Setting: Mixed models were used to analyze data from the Perindopril Protection Against Recurrent Stroke Study (PROGRESS). which examined the effects Of perindopril and indapamide in 6 105 Patients at high risk of a cerebrovascular event.Results: The mean effect of perindopril was to lower blood pressure (BP) (systolic/diastolic) by 6/3 mmHg. The mean effect, of perindopril/indapamide varied according to baseline BP, and lowering of BP ranged front 9/5 to 14/5 mmHg (for individuals with a baseline systolic BP 140 and > 150 mmHg, respectively). We found no variation in the effects of treatment on BP for either perindopril alone or in combination with indapamide. The effects of treatment on the individual can be predicted from the mean effect of treatment for the group (perindopril) or baseline systolic BP subgroup (perindopril/indapamide).Conclusion: Monitoring initial treatment response is unneccessary for antihypertensives similar to those examined in this study. To ad(tress this issue for other therapies, we suggest that trials should report estimates of treatment effects from mixed models, and the CONSORT statement should be expanded to include this item. (C) 2009 Elsevier Inc. All rights reserved.