Side effects and tolerability of combination blood pressure lowering according to blood pressure levels: an analysis of the PROGRESS and ADVANCE trials.
Identifieur interne : 000B57 ( PubMed/Corpus ); précédent : 000B56; suivant : 000B58Side effects and tolerability of combination blood pressure lowering according to blood pressure levels: an analysis of the PROGRESS and ADVANCE trials.
Auteurs : Emily R. Atkins ; Yoichiro Hirakawa ; Abdul Salam ; Mark Woodward ; Mark Cooper ; Pavel Hamet ; Stephen Harrap ; Kennedy Lees ; Lisheng Liu ; Giuseppe Mancia ; Michel Marre ; Vlado Perkovic ; Neil Poulter ; Bryan Williams ; John Chalmers ; Anthony RodgersSource :
- Journal of hypertension [ 1473-5598 ] ; 2017.
Abstract
To measure the placebo-controlled effects of combination therapy on hypotension, treatment discontinuation, and major renal outcomes, according to baseline blood pressure.
DOI: 10.1097/HJH.0000000000001287
PubMed: 28169881
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pubmed:28169881Le document en format XML
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<author><name sortKey="Atkins, Emily R" sort="Atkins, Emily R" uniqKey="Atkins E" first="Emily R" last="Atkins">Emily R. Atkins</name>
<affiliation><nlm:affiliation>aThe George Institute for Global Health bSydney Medical School, University of Sydney, Sydney, Australia cThe George Institute for Global Health, University of Oxford, Oxford, UK dBaker IDI Heart and Diabetes Institute, Melbourne, Australia eCentre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada fUniversity of Melbourne and Royal Melbourne Hospital, Melbourne, Australia gInstitute of Cardiovascular & Medical Sciences, BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK hChinese Hypertension League Institute, Beijing, China iUniversity of Milan-Bicocca and Istituto Auxologico Italiano, Milan, Italy jHôpital Bichat - Claude Bernard and Université Paris 7, Paris, France kInternational Centre for Circulatory Health, Imperial College lNational Institute for Health Research UCL Hospitals Biomedical Research Centre, London, UK.</nlm:affiliation>
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<author><name sortKey="Hirakawa, Yoichiro" sort="Hirakawa, Yoichiro" uniqKey="Hirakawa Y" first="Yoichiro" last="Hirakawa">Yoichiro Hirakawa</name>
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<author><name sortKey="Salam, Abdul" sort="Salam, Abdul" uniqKey="Salam A" first="Abdul" last="Salam">Abdul Salam</name>
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<author><name sortKey="Hamet, Pavel" sort="Hamet, Pavel" uniqKey="Hamet P" first="Pavel" last="Hamet">Pavel Hamet</name>
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<author><name sortKey="Harrap, Stephen" sort="Harrap, Stephen" uniqKey="Harrap S" first="Stephen" last="Harrap">Stephen Harrap</name>
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<author><name sortKey="Lees, Kennedy" sort="Lees, Kennedy" uniqKey="Lees K" first="Kennedy" last="Lees">Kennedy Lees</name>
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<author><name sortKey="Liu, Lisheng" sort="Liu, Lisheng" uniqKey="Liu L" first="Lisheng" last="Liu">Lisheng Liu</name>
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<author><name sortKey="Poulter, Neil" sort="Poulter, Neil" uniqKey="Poulter N" first="Neil" last="Poulter">Neil Poulter</name>
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<author><name sortKey="Williams, Bryan" sort="Williams, Bryan" uniqKey="Williams B" first="Bryan" last="Williams">Bryan Williams</name>
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<author><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name>
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<author><name sortKey="Rodgers, Anthony" sort="Rodgers, Anthony" uniqKey="Rodgers A" first="Anthony" last="Rodgers">Anthony Rodgers</name>
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<author><name sortKey="Atkins, Emily R" sort="Atkins, Emily R" uniqKey="Atkins E" first="Emily R" last="Atkins">Emily R. Atkins</name>
<affiliation><nlm:affiliation>aThe George Institute for Global Health bSydney Medical School, University of Sydney, Sydney, Australia cThe George Institute for Global Health, University of Oxford, Oxford, UK dBaker IDI Heart and Diabetes Institute, Melbourne, Australia eCentre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada fUniversity of Melbourne and Royal Melbourne Hospital, Melbourne, Australia gInstitute of Cardiovascular & Medical Sciences, BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK hChinese Hypertension League Institute, Beijing, China iUniversity of Milan-Bicocca and Istituto Auxologico Italiano, Milan, Italy jHôpital Bichat - Claude Bernard and Université Paris 7, Paris, France kInternational Centre for Circulatory Health, Imperial College lNational Institute for Health Research UCL Hospitals Biomedical Research Centre, London, UK.</nlm:affiliation>
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<author><name sortKey="Hirakawa, Yoichiro" sort="Hirakawa, Yoichiro" uniqKey="Hirakawa Y" first="Yoichiro" last="Hirakawa">Yoichiro Hirakawa</name>
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<author><name sortKey="Salam, Abdul" sort="Salam, Abdul" uniqKey="Salam A" first="Abdul" last="Salam">Abdul Salam</name>
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<author><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name>
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<author><name sortKey="Cooper, Mark" sort="Cooper, Mark" uniqKey="Cooper M" first="Mark" last="Cooper">Mark Cooper</name>
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<author><name sortKey="Hamet, Pavel" sort="Hamet, Pavel" uniqKey="Hamet P" first="Pavel" last="Hamet">Pavel Hamet</name>
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<author><name sortKey="Harrap, Stephen" sort="Harrap, Stephen" uniqKey="Harrap S" first="Stephen" last="Harrap">Stephen Harrap</name>
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<author><name sortKey="Lees, Kennedy" sort="Lees, Kennedy" uniqKey="Lees K" first="Kennedy" last="Lees">Kennedy Lees</name>
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<author><name sortKey="Liu, Lisheng" sort="Liu, Lisheng" uniqKey="Liu L" first="Lisheng" last="Liu">Lisheng Liu</name>
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<author><name sortKey="Mancia, Giuseppe" sort="Mancia, Giuseppe" uniqKey="Mancia G" first="Giuseppe" last="Mancia">Giuseppe Mancia</name>
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<author><name sortKey="Marre, Michel" sort="Marre, Michel" uniqKey="Marre M" first="Michel" last="Marre">Michel Marre</name>
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<author><name sortKey="Perkovic, Vlado" sort="Perkovic, Vlado" uniqKey="Perkovic V" first="Vlado" last="Perkovic">Vlado Perkovic</name>
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<author><name sortKey="Poulter, Neil" sort="Poulter, Neil" uniqKey="Poulter N" first="Neil" last="Poulter">Neil Poulter</name>
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<author><name sortKey="Williams, Bryan" sort="Williams, Bryan" uniqKey="Williams B" first="Bryan" last="Williams">Bryan Williams</name>
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<author><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name>
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<author><name sortKey="Rodgers, Anthony" sort="Rodgers, Anthony" uniqKey="Rodgers A" first="Anthony" last="Rodgers">Anthony Rodgers</name>
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<series><title level="j">Journal of hypertension</title>
<idno type="eISSN">1473-5598</idno>
<imprint><date when="2017" type="published">2017</date>
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<front><div type="abstract" xml:lang="en">To measure the placebo-controlled effects of combination therapy on hypotension, treatment discontinuation, and major renal outcomes, according to baseline blood pressure.</div>
</front>
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<pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28169881</PMID>
<DateCreated><Year>2017</Year>
<Month>02</Month>
<Day>07</Day>
</DateCreated>
<DateRevised><Year>2017</Year>
<Month>04</Month>
<Day>25</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1473-5598</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>35</Volume>
<Issue>6</Issue>
<PubDate><Year>2017</Year>
<Month>Jun</Month>
</PubDate>
</JournalIssue>
<Title>Journal of hypertension</Title>
<ISOAbbreviation>J. Hypertens.</ISOAbbreviation>
</Journal>
<ArticleTitle>Side effects and tolerability of combination blood pressure lowering according to blood pressure levels: an analysis of the PROGRESS and ADVANCE trials.</ArticleTitle>
<Pagination><MedlinePgn>1318-1325</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1097/HJH.0000000000001287</ELocationID>
<Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To measure the placebo-controlled effects of combination therapy on hypotension, treatment discontinuation, and major renal outcomes, according to baseline blood pressure.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We conducted an analysis of the action in diabetes and vascular disease: preterax and diamicron-MR controlled evaluation ADVANCE and perindopril protection against recurrent stroke study PROGRESS trials, including 14 684 participants allocated combination therapy or placebo. The mean age was 65 years, 61% were men, and 64% were receiving background blood pressure lowering (BPL) therapy. Participants were stratified into five subgroups by baseline SBP less than 120, 120-129, 130-139, 140-159, and at least 160 mmHg. Discontinuation of study treatment during the active run-in phase and postrandomization follow-up was assessed for hypotension/dizziness and other causes. Major renal outcomes (sustained doubling in creatinine or renal death) were also assessed.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Discontinuation during the 4-6-week active run-in phase due to hypotension/dizziness ranged from 3.6% in those with SBP less than 120 mmHg to 1.3% in those with SBP at least 160 mmHg. Median follow-up in the randomized phase was 5.6 years, and discontinuation for hypotension was higher with combination therapy compared with placebo in the less than 120 mmHg group (4.7 vs. 1.2%). However, for each subgroup with baseline SBP 120-129, 130-139, and 140-159 mmHg, the absolute excess of discontinuation due to hypotension with combination therapy was 0.7%. Total discontinuations were only increased in the less than 120 mmHg group (18.4 vs. 12.5%) and the 120-129-mmHg subgroup (17.6 vs. 14.2%). There were no clear differences across the SBP subgroups for the combined renal outcome (overall, 0.8 vs. 0.6%).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Compared with those with baseline SBP 140-159 mmHg, side effects of dual combination BPL are essentially the same for people with SBP 130-139 mmHg and only modestly increased among patients with SBP 120-129 mmHg. During long-term therapy, side effects sufficient to stop treatment that are treatment related (i.e. occur in excess of rates seen with placebo) occur at less than 0.5%/year in patients with baseline SBP 120-139 mmHg. These results have important implications in assessing the likely balance of benefits and side effects of BPL with combination therapy among those with SBP 120-139 mmHg.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Atkins</LastName>
<ForeName>Emily R</ForeName>
<Initials>ER</Initials>
<AffiliationInfo><Affiliation>aThe George Institute for Global Health bSydney Medical School, University of Sydney, Sydney, Australia cThe George Institute for Global Health, University of Oxford, Oxford, UK dBaker IDI Heart and Diabetes Institute, Melbourne, Australia eCentre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada fUniversity of Melbourne and Royal Melbourne Hospital, Melbourne, Australia gInstitute of Cardiovascular & Medical Sciences, BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, UK hChinese Hypertension League Institute, Beijing, China iUniversity of Milan-Bicocca and Istituto Auxologico Italiano, Milan, Italy jHôpital Bichat - Claude Bernard and Université Paris 7, Paris, France kInternational Centre for Circulatory Health, Imperial College lNational Institute for Health Research UCL Hospitals Biomedical Research Centre, London, UK.</Affiliation>
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<Author ValidYN="Y"><LastName>Hirakawa</LastName>
<ForeName>Yoichiro</ForeName>
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<Author ValidYN="Y"><LastName>Salam</LastName>
<ForeName>Abdul</ForeName>
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<ForeName>Pavel</ForeName>
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<Author ValidYN="Y"><LastName>Harrap</LastName>
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<Initials>S</Initials>
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<Author ValidYN="Y"><LastName>Lees</LastName>
<ForeName>Kennedy</ForeName>
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<Author ValidYN="Y"><LastName>Liu</LastName>
<ForeName>Lisheng</ForeName>
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<Author ValidYN="Y"><LastName>Mancia</LastName>
<ForeName>Giuseppe</ForeName>
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<ForeName>Michel</ForeName>
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<Author ValidYN="Y"><LastName>Perkovic</LastName>
<ForeName>Vlado</ForeName>
<Initials>V</Initials>
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<Initials>N</Initials>
</Author>
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<ForeName>Bryan</ForeName>
<Initials>B</Initials>
</Author>
<Author ValidYN="Y"><LastName>Chalmers</LastName>
<ForeName>John</ForeName>
<Initials>J</Initials>
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<Author ValidYN="Y"><LastName>Rodgers</LastName>
<ForeName>Anthony</ForeName>
<Initials>A</Initials>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
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</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>J Hypertens</MedlineTA>
<NlmUniqueID>8306882</NlmUniqueID>
<ISSNLinking>0263-6352</ISSNLinking>
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