高血压治疗指南和进展.pptVIP

HOT Study Risk of a major cardiovascular event reduced by 30%  TROPHY: 高血压发生率 * Patients will be randomized to amlodipine/benazepril 5/20 mg or benazepril/HCTZ 20/12.5 mg, and will have their doses force-titrated to standard maintenance doses of amlodipine/benazepril 5/40 mg, and benazepril/HCTZ 40/12.5 mg during the first 2 months. The doses can be increased to 10/40 mg or 40/25 mg, respectively, and after 3 months other antihypertensive agents (excluding the drug classes involved in the primary treatments) may be added to achieve blood pressure 140/90 mmHg (130/80 mmHg for patients with diabetes or renal insufficiency). Investigators will be strongly encouraged to reach target blood pressure in all patients. Patients will be seen at 3 months, 6 months, and thereafter at 6-month intervals until the end of the trial.1 (Jamerson et al. Am J Hypertens. 2004;17: A) ACCOMPLISH is an event-driven trial: patients will be treated until 1,642 primary cardiovascular events have been reported. It is estimated this will take approximately 5 years, including the 18 months of recruitment. 1. Jamerson KA, Bakris GL, Wun CC, et al. Rationale and design of the Avoiding Cardiovascular events through COMbination therapy in Patients LIving with Systolic Hypertension (ACCOMPLISH) trial: the first randomized controlled trial to compare the clinical outcome effects of first-line combination therapies in hypertension. Am J Hypertens. 2004;17:793–801. ADVANCE Investigator mtg ESC * 9. Vasan RS, Larsen MG, Leip EP, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med. 2001;345:1291-1297. Studies have shown that risk of CVD is increased even at levels of BP considered to be high-normal. The cardiovascular (CV) event rates of 6589 patients from the Framingham Study who had high-normal, normal, or optimal BP at baseline (as defined above) were recorded over 14 years. Men and women with high-normal BP at baseline had a higher incidence of CVD on