Principal Results of the Japanese Trial to Assess Optimal Systolic Blood Pressure in Elderly Hypertensive Patients (JATOS)
Principal Results of the Japanese Trial to Assess Optimal Systolic Blood Pressure in Elderly Hypertensive Patients (JATOS)
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DOI：
10.1291/hypres.31.2115
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发表时间：
2008-12-01
影响因子：
5.4
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中科院分区：
文献类型：
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将老年高血压患者的收缩压降至140毫米汞柱以下的益处仍然存在争议。这项研究是一项前瞻性、随机、开放的研究，对终点进行盲法评估，以比较老年高血压患者严格治疗将收缩压维持在140毫米汞柱以下与温和治疗将收缩压维持在160以下但在140毫米汞或以上的两年效果。将65~85岁、治疗前收缩压>160 mm Hg的高血压病患者随机分为严格治疗组(n=2 212)和轻度治疗组(n=2 206)。基线药物是长效钙拮抗剂盐酸伊福地平。主要终点是心血管疾病和肾功能衰竭的综合发生率，次要终点是总死亡率和任何安全问题。尽管严格治疗组的末期血压(收缩压/舒张压)明显低于轻度治疗组(135.9/74.8vs.145.6/78.1mmHg；p
The benefits of lowering a systolic blood pressure below 140 mmHg in elderly hypertension remain controversial. This study is a prospective, randomized, open-label study with blinded assessment of endpoints to compare the 2-year affect of strict treatment to maintain systolic blood pressure below 140 mmHg with that of mild treatment to maintain systolic blood pressure below 160 but at or above 140 mmHg in elderly hypertensive patients. Patients with essential hypertension (65-85 years old, with a pretreatment systolic blood pressure of above 160 mmHg) were randomly assigned to receive strict treatment (n=2,212) or mild treatment (n=2,206). The baseline drug was efonidipine hydrochloride, a long-acting calcium antagonist. The primary endpoint was the combined incidence of cardiovascular disease and renal failure, and the secondary endpoints were total deaths and any safety problems. Although final blood pressures (systolic/diastolic) were significantly lower in the strict-treatment group compared with the mild-treatment group (135.9/74.8 vs. 145.6/78.1 mmHg; p