SPARTE Study: Normalization of Arterial Stiffness and Cardiovascular Events in Patients With Hypertension at Medium to Very High Risk
| Autor: | Helena Pereira, Krzysztof Narkiewicz, Hakim Khettab, Pierre Boutouyrie, Nicolas Danchin, Jean-Jacques Mourad, Sparte Investigators, Pascal Delsart, Stéphane Laurent, Gilles Chatellier, Xavier Girerd, Philippe Gosse, Michel Azizi, Dominique Stephan, David Calvet, Gabriel Choukroun, Rosa-Maria Bruno, Gérard M. London, Pedro P. Cunha, Paul Valensi, Bruno Pannier |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty hypertension renin-angiotensin system Pulse Wave Analysis law.invention Randomized controlled trial law Internal medicine Internal Medicine Humans Medicine Prospective Studies Stroke Pulse wave velocity surrogate end point Aged business.industry Surrogate endpoint Hazard ratio blood pressure vascular stiffness clinical trial Original Articles Middle Aged medicine.disease Blood pressure Cardiovascular Diseases Ambulatory ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Arterial stiffness Cardiology Arterial Stiffness Female business |
| Zdroj: | Hypertension (Dallas, Tex. : 1979) |
| ISSN: | 1524-4563 0194-911X |
| DOI: | 10.1161/hypertensionaha.121.17579 |
| Popis: | Supplemental Digital Content is available in the text. The SPARTE study (Strategy for Preventing cardiovascular and renal events based on ARTErial stiffness; URL: https://www.clinicaltrials.gov; Unique identifier: NCT02617238) is a multicenter open-label randomized controlled trial with blinded end point evaluation, undertaken at 25 French research centers in university hospitals. Patients with primary hypertension were randomly assigned (1:1) to a therapeutic strategy targeting the normalization of carotid-femoral pulse wave velocity (PWV) measured every 6 months (PWV group, n=264) versus a classical therapeutic strategy only implementing the European Guidelines for Hypertension Treatment (conventional group, n=272). In the PWV group, the therapeutic strategy used preferably a combination of ACE (angiotensin-converting enzyme) inhibitor or angiotensin receptor blocker and calcium channel blockers, as well as maximal recommended doses of ACE inhibitors and angiotensin receptor blockers. The primary outcome was a combined end point including particularly stroke and coronary events. Secondary outcomes included the time-course changes in brachial office blood pressure (BP), ambulatory BP, PWV, and treatments. After a median follow-up of 48.3 months, there was no significant between-group difference in primary outcome (hazard ratio, 0.74 [95% CI, 0.40–1.38], P=0.35). In the PWV group, combinations of renin-angiotensin-system blockers and calcium channel blockers were prescribed at higher dosage (P=0.028), office and ambulatory systolic blood pressure and diastolic blood pressure decreased more (P |
| Databáze: | OpenAIRE |
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