TREATMENT OF MILD HYPERTENSION STUDY - FINAL RESULTS
TREATMENT OF MILD HYPERTENSION STUDY - FINAL RESULTS
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DOI：
10.1001/jama.270.6.713
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发表时间：
1993-08-11
影响因子：
120.7
通讯作者：
LIEBSON, PR
中科院分区：
文献类型：
--
作者：
NEATON, JD;GRIMM, RH;LIEBSON, PR
目的.-比较治疗轻度高血压的六种抗高血压干预措施。设计.-随机、双盲、安慰剂对照临床试验。设置.-美国四个高血压筛查和治疗中心。参与者.-高血压男性和女性，年龄 45 至 69 岁，舒张压低于 100 毫米汞柱。干预措施.-持续 向所有参与者提供减少体重、膳食钠摄入量和酒精摄入量以及增加体力活动的营养卫生建议。参与者被随机分配服用（1）安慰剂（n=234）； (2)氯噻酮(n=136)； (3)醋丁洛尔(n=132)； (4)甲磺酸多沙唑嗪(n=134)； (5)马来酸氨氯地平(n=131)； (6) 马来酸依那普利 (n=135)。主要结果指标。-血压、生活质量、副作用、血脂水平和其他血清成分分析、超声心动图和心电图变化以及平均 4.4 年随访期间心血管事件的发生率。结果。-所有六组的血压降低幅度都很大，分配到药物治疗的参与者的血压降低幅度明显更大 高于安慰剂（收缩压为-15.9 毫米汞柱与-9.1 毫米汞柱，舒张压为-12.3 毫米汞柱与-8.6 毫米汞柱；P
Objective.-To compare six antihypertensive interventions for the treatment of mild hypertension.Design.-Randomized, double-blind, placebo-controlled clinical trial.Setting.-Four hypertension screening and treatment centers in the United States.Participants.-Hypertensive men and women, aged 45 to 69 years, with diastolic blood pressure less than 100 mm Hg.Intervention.-Sustained nutritional-hygienic advice to all participants to reduce weight, dietary sodium intake, and alcohol intake, and increase physical activity. Participants were randomly allocated to take (1) placebo (n=234); (2) chlorthalidone (n=136); (3) acebutolol (n=132); (4) doxazosin mesylate (n=134); (5) amlodipine maleate (n=131); or (6) enalapril maleate (n=135).Main Outcome Measures.-Blood pressure, quality of life, side effects, blood lipid levels and analysis of other serum components, echocardiographic and electrocardiographic changes, and incidence of cardiovascular events over an average of 4.4 years of follow-up.Results.-Blood pressure reductions were sizable in all six groups, and were significantly greater for participants assigned to drug treatment than placebo (-15.9 vs -9.1 mm Hg for systolic blood pressure and -12.3 vs -8.6 mm Hg for diastolic blood pressure; P