ANTIHYPERTENSIVE AND LIPID LOWERING TREATMENT TO PREVENT HEART ATTACK

三种新型降压药赖诺普利、利多卡因和多沙佐星与标准利尿剂治疗的疗效比较据估计，美国有5000万人患有高血压或正在服用高血压药物。高血压和冠心病（CHD）之间的关系是已知的，但大规模的，在轻度至中度高血压的随机临床试验中，主要是中年受试者未能显示高血压药物治疗降低心脏病死亡或非致命性心肌梗死（由于缺乏血液供应的心脏组织的死亡）的发生。本试验的主要假设是，接受三种药物治疗的高血压患者的致死性心脏病和非致死性心肌梗死的合并发生率较低。这项研究将涉及55岁及以上的男性和女性，除了高血压外，所有人都至少有一个额外的冠心病风险因素，其中55%将是非洲裔美国人，这是一个更容易患高血压的种族。将有一个降低血压的试验部分和一个降低胆固醇的试验部分。将随机分配研究药物。患者将每四个星期接受一次就诊，直到达到合理稳定的治疗方案并达到令人满意的血压控制。第一年每三个月进行一次诊所访问，此后每四个月进行一次。每次访视时测量血压。将在访视2时进行心电图检查。将在一个月、一年、两年、四年和六年时检查钾水平。将进行血液检查以及血清肌酐检查。空腹胆固醇和血糖。每次访视时，将确定研究药物的依从性。将在研究开始时和此后每年讨论生活质量。

A determination of effectiveness of three new blood pressure-lowering drugs; lisinopril, amlodipine, and doxazocin as compared to the standard forms of treatment with diuretic drugs. An estimated 50 million people in the United States have elevated blood pressure or are taking medications for high blood pressure. There is known relationship between high blood pressure and coronary heart disease (CHD), but large-scale, randomized clinical trials in mild to moderately high blood pressure in largely middle-aged subjects failed to show that high blood pressure drug treatment reduces the occurrence of cardiac disease death or non-fatal myocardial infarction (the death of heart tissue due to lack of blood supply to the area). The primary hypothesis of this trial is that the combined incidence of fatal heart disease and non-fatal myocardial infarction will be lower in patients with high blood pressure who receive the three medications. The study will involve a population of men and women 55 years and older, all with at least one additional CHD risk factor besides high blood pressure, 55% of whom will be African-American, a race more prone to high blood pressure. There will be a trial component to lower blood pressure and a trial component to lower cholesterol. Study drugs will be randomly assigned. Patients will be seen at four week intervals until a reasonably stable regimen with satisfactory blood pressure control has been achieved. Clinic visits will then take place every three months during the first year and every four months thereafter. Blood pressure will be taken at each visit. An electrocardiogram test will be given at visit two. Potassium levels will be checked at one month, one year, two years, four years, and at six years. Blood tests will be done as well as tests for creatinine serum., fasting cholesterol, and serum glucose. At every visit, a determination of compliance with study medications will be done. Quality of life will be discussed at the entry of the study and every year thereafter.