Journal ArticleDOI
Results of the Controlled ONset Verapamil INvestigation of Cardiovascular Endpoints (CONVINCE) trial by geographical region.
Henry R. Black,William J. Elliott,Gregory A Grandits,Patricia Grambsch,Tracy Lucente,James D. Neaton,Richard H. Grimm,Lennart Hansson,Yves Lacourcière,James E. Muller,Peter Sleight,Michael A. Weber,William B. White,Gordon H. Williams,Janet Wittes,Alberto Zanchetti,Robert J. Anders +16 more
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TLDR
Although baseline factors, blood pressure control and event rates varied by region, treatment differences did not, and the absence of treatment differences by region suggests that the overall findings of CONVINCE are robust.Abstract:
Objective To examine regional differences in the Controlled ONset Verapamil INvestigation of Cardiovascular Endpoints (CONVINCE) trial. Design Double-blind, randomized, international clinical trial. Setting Six hundred and sixty-one clinical centers in 15 countries. Patients Hypertensive volunteers (n = 16,602) with > or =1 additional cardiovascular risk factor, grouped into four regions: USA (n = 8144), Canada (n = 3405), Western Europe (Spain, UK, Italy, Sweden, Germany; n = 2048) or 'other' (Bulgaria, Israel, Mexico, Czech Republic, Hungary, Poland, Slovakia, Brazil; n = 2879); subgroupings included country and state/province within the USA and Canada. Interventions Randomized to COER-verapamil or the investigator's choice of either atenolol or hydrochlorothiazide, titrated and additional drugs added as required. Main outcome measures Baseline characteristics; blood pressure control, medication adherence and lost-to-follow-up at 2 years; and composite primary endpoint (stroke, myocardial infarction, cardiovascular death) by regional groupings. Results Regional differences were found at baseline for age, gender, blood pressure, percentage receiving antihypertensive drug therapy, initial choice of atenolol or hydrochlorothiazide, and risk factor profile. Blood pressure control rates increased markedly during follow-up in all regions, but varied significantly by region. Blood pressure control, medication adherence and lost-to-follow-up rates were poorest in the USA. After adjustment for baseline differences, the primary-event rate for each region was significantly lower than for the USA. Although baseline factors, blood pressure control and event rates varied by region, treatment differences did not. Conclusion Despite differences in baseline and follow-up measures across geographical regions, the absence of treatment differences by region suggests that the overall findings of CONVINCE are robust.read more
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Chronobiology, drug delivery, and chronotherapeutics.
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References
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Journal ArticleDOI
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.
Aram V. Chobanian,George L. Bakris,Henry R. Black,William C. Cushman,Lee A. Green,Joseph L. Izzo,Daniel W. Jones,Barry J. Materson,Suzanne Oparil,Jackson T. Wright,Edward J. Roccella +10 more
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
Journal ArticleDOI
Effects of an angiotensin-converting -enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients
TL;DR: Ramipril significantly reduces the rates of death, myocardial infarction, and stroke in a broad range of high-risk patients who are not known to have a low ejection fraction or heart failure.
Journal ArticleDOI
Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial
Lennart Hansson,Alberto Zanchetti,S. George Carruthers,Björn Dahlöf,Dag Elmfeldt,Stevo Julius,Joël Ménard,Karl Heinz Rahn,Hans Wedel,Sten Westerling +9 more
TL;DR: Intensive lowering of blood pressure in patients with hypertension was associated with a low rate of cardiovascular events and the potential benefit of a low dose of acetylsalicylic acid in the treatment of hypertension was assessed.
Journal ArticleDOI
Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol.
Björn Dahlöf,Richard B. Devereux,Sverre E. Kjeldsen,Stevo Julius,Gareth Beevers,Ulf de Faire,Frej Fyhrquist,Hans Ibsen,Krister Kristiansson,Ole Lederballe-Pedersen,Lars H Lindholm,Markku S. Nieminen,Per Omvik,Suzanne Oparil,Hans Wedel +14 more
TL;DR: Losartan prevents more cardiovascular morbidity and death than atenolol for a similar reduction in blood pressure and is better tolerated, while new-onset diabetes was less frequent with losartan.
Journal ArticleDOI
The seventh report of the joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. The JNC 7 report
Aram V. Chobanian,George L. Bakris,Henry R. Black,William C. Cushman,Lee A. Green,Joseph L. Izzo,Daniel W. Jones,Barry J. Materson,Suzanne Oparil,J.T. Wright,J. R. Toccella,Edward J. Rocella,Melissa M. Brown +12 more
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
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