Feasibility of treating prehypertension with an angiotensin-receptor blocker
Feasibility of treating prehypertension with an angiotensin-receptor blocker
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DOI：
10.1056/nejmoa060838
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发表时间：
2006-04-20
影响因子：
158.5
通讯作者：
Schork, MA
中科院分区：
文献类型：
--
作者：
Julius, S;Nesbitt, SD;Schork, MA
背景：高血压前期被认为是1期高血压的前兆，是过度心血管风险的预测因子。我们调查了高血压前期的药物治疗是否可以预防或推迟第1阶段的高血压。方法：重复测量收缩压为130至139毫米汞柱和舒张压为89毫米汞柱或更低，或收缩压为139毫米汞柱或更低，舒张压为85至89毫米汞柱的参与者，被随机分配接受两年的坎地沙坦（Atacand，阿斯利康）或安慰剂，随后两年的安慰剂。当受试者达到研究终点1期高血压时，开始接受降压药治疗。坎地沙坦组和安慰剂组都被指示改变生活方式，以降低血压在整个trial.Results：共有409名参与者被随机分配到坎地沙坦，400安慰剂。772名参与者的数据（坎地沙坦组391人，安慰剂组381人;平均年龄48.5岁; 59.6%为男性）可用于分析。在最初的两年里，安慰剂组有154名参与者和坎地沙坦组有53名参与者发生了高血压（相对风险降低66.3%; P
BACKGROUND:Prehypertension is considered a precursor of stage 1 hypertension and a predictor of excessive cardiovascular risk. We investigated whether pharmacologic treatment of prehypertension prevents or postpones stage 1 hypertension.METHODS:Participants with repeated measurements of systolic pressure of 130 to 139 mm Hg and diastolic pressure of 89 mm Hg or lower, or systolic pressure of 139 mm Hg or lower and diastolic pressure of 85 to 89 mm Hg, were randomly assigned to receive two years of candesartan (Atacand, AstraZeneca) or placebo, followed by two years of placebo for all. When a participant reached the study end point of stage 1 hypertension, treatment with antihypertensive agents was initiated. Both the candesartan group and the placebo group were instructed to make changes in lifestyle to reduce blood pressure throughout the trial.RESULTS:A total of 409 participants were randomly assigned to candesartan, and 400 to placebo. Data on 772 participants (391 in the candesartan group and 381 in the placebo group; mean age, 48.5 years; 59.6 percent men) were available for analysis. During the first two years, hypertension developed in 154 participants in the placebo group and 53 of those in the candesartan group (relative risk reduction, 66.3 percent; P