Journal ArticleDOI
Twenty-four hour ambulatory blood pressure in the International Nifedipine GITS Study Intervention as a Goal in Hypertension Treatment (INSIGHT).
Reads0
Chats0
TLDR
In the INSIGHT study, the long-term antihypertensive effect on 24 h blood pressure and the cardiovascular protection of nifedipine was similar to that of diuretics, thus demonstrating a similar well-balanced anti Hypertensive response to both drugs.Abstract:
Objectives The International Nifedipine GITS Study Intervention as a Goal in Hypertension Treatment (INSIGHT) showed, by means of office blood pressure measurements, that long-term treatment with nifedipine GITS is as effective as diuretics in preventing cardiovascular and cerebrovascular complications. However, since office blood pressure measurements reflect to a limited extent blood pressure outside the office, a side-arm INSIGHT study in which patients underwent both office measurement and 24 h ambulatory blood pressure monitoring was also performed. Design and methods The study had a randomized, double-blind, parallel group design. After 4 weeks of placebo, mild-to-moderate essential hypertensive patients were randomized to nifedipine GITS 30 mg or amiloride 2.5 + hydrochlorothiazide 5 mg for 3.1 years. Dose titration was performed by dose doubling and addition of atenolol 25–50 mg or enalapril 5–10 mg, or other drugs when needed. Analysis was carried out by intention-to-treat and included computation of 24 h, day and night ambulatory blood pressure and heart rate values. Additional analyses included computation of the trough-to-peak ratio and the smoothness index (the ratio between the average of the 24-hourly blood pressure reductions after treatment and its standard deviation). Results A total of 151 patients were recruited and 149 were valid for analysis: 78 patients had 24 h ambulatory recordings both at baseline and during treatment and 134 during treatment. Office, 24 h and day and night blood pressures were all significantly and similarly reduced by both treatments. Office and ambulatory heart rate was left unchanged by diuretics, while it was slightly reduced by nifedipine. Median trough-to-peak ratios were always > 0.5 and superimposable between the two treatment groups. Similarly, smoothness indices of systolic and diastolic blood pressures were comparably high for nifedipine and diuretics, thus demonstrating a similar well-balanced antihypertensive response to both drugs. No significant differences were observed between the two treatment groups in the number of cardiovascular events (17 in the nifedipine-based and 26 in the diuretics-based treatment group). Conclusions In the INSIGHT study, the long-term antihypertensive effect on 24 h blood pressure and the cardiovascular protection of nifedipine was similar to that of diuretics.read more
Citations
More filters
Journal ArticleDOI
Office compared with ambulatory blood pressure in assessing response to antihypertensive treatment: a meta-analysis.
TL;DR: The results showed that treatment-induced reduction in blood pressure is both smaller for the 24-h average than for the office systolic and diastolic blood pressure and smaller for night-time than for daytime average diastolics blood pressure.
Journal ArticleDOI
Noninvasive 24-h ambulatory blood pressure and cardiovascular disease: a systematic review and meta-analysis.
David Conen,Fabian Bamberg +1 more
TL;DR: 24-h systolic blood pressure is a strong predictor of cardiovascular events, providing prognostic information independent of conventional office blood pressure.
Journal ArticleDOI
Systematic review of the effect of daily alcohol intake on blood pressure.
TL;DR: It is indicated that the timing of BP measurements after alcohol intake has a substantial effect on the magnitude and perhaps even the direction of BP change, and may have important implications for interpreting studies measuring the effect of alcohol on BP as well as for regular clinical care.
Journal ArticleDOI
Administration-Time Differences in Effects of Hypertension Medications on Ambulatory Blood Pressure Regulation
Ramon C. Hermida,Diana E. Ayala,José R. Fernández,Artemio Mojón,Michael H. Smolensky,Fabio Fabbian,Francesco Portaluppi +6 more
TL;DR: The chronotherapy of conventional hypertension medications constitutes a new and cost-effective strategy for enhancing the control of daytime and nighttime SBP and DBP levels, normalizing the dipping status of their 24-h patterning, and potentially reducing the risk of CVD events and end-organ injury.
Prise en charge des patients adultes atteints d'hypertension artérielle essentielle
De Sante,Haute Autorité +1 more
TL;DR: L’HTA est définie de façon consensuelle par une PAS 140mmHg et/ou une PAD 90 mmHg, mesurées au cabinet médical, and confirmées (au minimum par 2 mesures par consultation, au cours of 3 consultations successives, sur une période de 3 à 6 mois).
References
More filters
Journal ArticleDOI
Ambulatory blood pressure. An independent predictor of prognosis in essential hypertension.
Paolo Verdecchia,Carlo Porcellati,Giuseppe Schillaci,Claudia Borgioni,Antonella Ciucci,Massimo Battistelli,M Guerrieri,Camillo Gatteschi,Ivano Zampi,Antonella Santucci,Carla Santucci,Gianpaolo Reboldi +11 more
TL;DR: It is suggested that ambulatory blood pressures stratifies cardiovascular risk in essential hypertension independent of clinic blood pressure and other traditional risk markers including echocardiographic left ventricular hypertrophy.
Journal ArticleDOI
Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension.
Jan A. Staessen,Lutgarde Thijs,Robert Fagard,Eoin O'Brien,Clement D,P. W. De Leeuw,Giuseppe Mancia,C Nachev,Paolo Palatini,Gianfranco Parati,J Tuomilehto,John Webster +11 more
TL;DR: In untreated older patients with isolated Systolic Hypertension in Europe, ambulatory systolic BP was a significant predictor of cardiovascular risk over and above conventional BP.
Journal ArticleDOI
Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension in the Adult US Population: Data From the Health Examination Surveys, 1960 to 1991
Vicki L. Burt,Jeffrey A. Cutler,Millicent Higgins,Michael J. Horan,Darwin R. Labarthe,Paul K. Whelton,Clarice Brown,Edward J. Roccella +7 more
TL;DR: In this paper, the authors describe secular trends in the distribution of blood pressure and prevalence of hypertension in US adults and changes in rates of awareness, treatment, and control of hypertension.
Journal ArticleDOI
Morbidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment (INSIGHT)
Morris J. Brown,Christopher R. Palmer,Alain Castaigne,Peter W. de Leeuw,Giuseppe Mancia,Talma Rosenthal,Luis M. Ruilope +6 more
TL;DR: Nifedipine once daily and co-amilozide were equally effective in preventing overall cardiovascular or cerebrovascular complications in high-risk patients with hypertension.
Journal ArticleDOI
Relationship of 24-hour blood pressure mean and variability to severity of target-organ damage in hypertension.
TL;DR: The findings demonstrate that the severity of hypertension is more closely related to 24-h mean BP than to cuff BP values, and confirmed that 24-H BP may be variably different from cuff BP among subjects.
Related Papers (5)
2003 European society of hypertension - European Society of Cardiology guidelines for the management of arterial hypertension
Giuseppe Mancia,Enrico Agabiti Rosei,Renata Cifkova,G DeBacker,Serap Erdine,Robert Fagard,Csaba Farsang,Antony M. Heagerty,K Kawecka-Jaszcs,Wolfgang Kiowski,Sverre E. Kjeldsen,Thomas F. Lüscher,Gordon T. McInnes,Jean-Michel Mallion,Eoin O. Brien,Neil Poulter,Silvia G. Priori,Karl Heinz Rahn,Jose L. Rodicio,L. Ruilope,M. E. Safar,Jan A. Staessen,P. A. Van Zwieten,Bernard Waeber,Bryan Williams,Alberto Zanchetti,Faiez Zannad +26 more