Randomised trial of effects of calcium antagonists compared with diuretics and β-blockers on cardiovascular morbidity and mortality in hypertension:: the Nordic Diltiazem (NORDIL) study
Randomised trial of effects of calcium antagonists compared with diuretics and β-blockers on cardiovascular morbidity and mortality in hypertension:: the Nordic Diltiazem (NORDIL) study
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DOI：
10.1016/s0140-6736(00)02526-5
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发表时间：
2000-07-29
期刊：
影响因子：
168.9
通讯作者：
Karlberg, BE
中科院分区：
文献类型：
--
作者：
Hansson, L;Hedner, T;Karlberg, BE
背景钙拮抗剂是高血压的一线治疗药物。地尔硫卓（一种非二氢吡啶类钙拮抗剂）在降低心血管发病率或死亡率方面的有效性尚不清楚。我们比较了地尔硫卓与利尿剂，β-受体阻滞剂，或两者对心血管疾病的发病率和死亡率在高血压patients.Methods的前瞻性，随机，开放，盲法终点研究，我们招募了10 881例患者，年龄在50-74岁，在挪威和瑞典的健康中心，舒张压为100毫米汞柱或以上。我们将患者随机分配为地尔硫卓、利尿剂、β受体阻滞剂或两者兼而有之。合并的主要终点是致死性和非致死性卒中、心肌梗死和其他心血管死亡。结果地尔硫卓、利尿剂和β受体阻滞剂组的收缩压和舒张压均有效降低（降低20.3/18.7 mm Hg vs 23.3/18.7 mm Hg;收缩压降低差异显著（P <0.05）。
Background Calcium antagonists are a first-line treatment for hypertension. The effectiveness of diltiazem, a nondihydropyridine calcium antagonist, in reducing cardiovascular morbidity or mortality is unclear. We compared the effects of diltiazem with that of diuretics, beta-blockers, or both on cardiovascular morbidity and mortality in hypertensive patients.Methods In a prospective, randomised, open, blinded endpoint study, we enrolled 10 881 patients, aged 50-74 years, at health centres in Norway and Sweden, who had diastolic blood pressure of 100 mm Hg or more. We randomly assigned patients diltiazem, or diuretics, beta-blockers, or both. The combined primary endpoint was fatal and non-fatal stroke, myocardial infarction, and other cardiovascular death. Analysis was done by intention to treat.Findings Systolic and diastolic blood pressure were lowered effectively in the diltiazem and diuretic and beta-blocker groups (reduction 20.3/18.7 vs 23.3/18.7 mm Hg; difference in systolic reduction p