George Bakris MD, Allen Hester PhD, Michael Weber MD, Bjorn Dahlof MD, Bert Pitt MD, Eric Velasquez MD, Linda Staikos-Byrne PhD, Victor Shi PhD, Ken Jamerson MD, on behalf of the ACCOMPLISH Investigators
{"title":"收缩期高血压患者通过联合治疗避免心血管事件的糖尿病亚组基线特征(ACCOMPLISH)试验","authors":"George Bakris MD, Allen Hester PhD, Michael Weber MD, Bjorn Dahlof MD, Bert Pitt MD, Eric Velasquez MD, Linda Staikos-Byrne PhD, Victor Shi PhD, Ken Jamerson MD, on behalf of the ACCOMPLISH Investigators","doi":"10.1111/j.1559-4572.2008.00023.x","DOIUrl":null,"url":null,"abstract":"<p>The Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) trial is the first cardiovascular outcome trial designed to compare initial use of 2 different fixed-dose antihypertensive regimens, benazepril plus hydrochlorothiazide vs benazepril plus amlodipine, on cardiovascular end points in hypertensive patients at high cardiovascular risk secondary to previous major events or presence of diabetes mellitus (DM). Of the 11,464 patients, 60.4% had DM. Compared with non-DM patients, DM patients were less likely to have previous myocardial infarctions (15% vs 37%) or strokes (8% vs 21%). Those with DM were more likely to be female (43% vs 34%), black (15% vs 8%), overweight (body mass index, 32 vs 29 kg/m<sup>2</sup>). At baseline, DM patients were more likely to have the metabolic syndrome, manifested by higher levels of fasting glucose (145 vs 101 mg/dL) and triglycerides (178 vs 150 mg/dL) and slightly lower high-density lipoprotein cholesterol values (48 vs 51 mg/dL) compared to the non-DM cohort. Although estimated glomerular filtration rate (80 vs 76 mL/min/1.73 m<sup>2</sup>) was similar in the DM and non-DM groups, presence of both albuminuria (8.7% vs 3.5%) and microalbuminuria (29% vs 20%) were more prevalent in the DM group. After 6 months of treatment, blood pressure control rates (<140/90 mm Hg) using blinded data (both therapeutic groups combined) for DM demonstrated that 42.8% of DM patients had blood pressure levels <130/80 mm Hg. ACCOMPLISH will provide valuable guidance on optimizing treatment strategies in hypertensive patients at high cardiovascular risk with and without DM.</p>","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"3 4","pages":"229-233"},"PeriodicalIF":0.0000,"publicationDate":"2008-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1559-4572.2008.00023.x","citationCount":"11","resultStr":"{\"title\":\"The Diabetes Subgroup Baseline Characteristics of the Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) Trial\",\"authors\":\"George Bakris MD, Allen Hester PhD, Michael Weber MD, Bjorn Dahlof MD, Bert Pitt MD, Eric Velasquez MD, Linda Staikos-Byrne PhD, Victor Shi PhD, Ken Jamerson MD, on behalf of the ACCOMPLISH Investigators\",\"doi\":\"10.1111/j.1559-4572.2008.00023.x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>The Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) trial is the first cardiovascular outcome trial designed to compare initial use of 2 different fixed-dose antihypertensive regimens, benazepril plus hydrochlorothiazide vs benazepril plus amlodipine, on cardiovascular end points in hypertensive patients at high cardiovascular risk secondary to previous major events or presence of diabetes mellitus (DM). Of the 11,464 patients, 60.4% had DM. Compared with non-DM patients, DM patients were less likely to have previous myocardial infarctions (15% vs 37%) or strokes (8% vs 21%). Those with DM were more likely to be female (43% vs 34%), black (15% vs 8%), overweight (body mass index, 32 vs 29 kg/m<sup>2</sup>). At baseline, DM patients were more likely to have the metabolic syndrome, manifested by higher levels of fasting glucose (145 vs 101 mg/dL) and triglycerides (178 vs 150 mg/dL) and slightly lower high-density lipoprotein cholesterol values (48 vs 51 mg/dL) compared to the non-DM cohort. Although estimated glomerular filtration rate (80 vs 76 mL/min/1.73 m<sup>2</sup>) was similar in the DM and non-DM groups, presence of both albuminuria (8.7% vs 3.5%) and microalbuminuria (29% vs 20%) were more prevalent in the DM group. 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引用次数: 11
摘要
收缩期高血压患者通过联合治疗避免心血管事件(ACCOMPLISH)试验是第一个心血管结局试验,旨在比较两种不同固定剂量降压方案(苯那普利加氢氯噻嗪与苯那普利加氨氯地平)在高血压患者心血管终点上的初始使用情况,这些高血压患者继发于既往重大事件或存在糖尿病(DM)。在11,464名患者中,60.4%患有糖尿病。与非糖尿病患者相比,糖尿病患者既往心肌梗死(15%对37%)或中风(8%对21%)的可能性较小。糖尿病患者多为女性(43%对34%)、黑人(15%对8%)、超重(体重指数,32对29 kg/m2)。在基线时,与非糖尿病患者相比,糖尿病患者更容易出现代谢综合征,表现为空腹血糖(145 vs 101 mg/dL)和甘油三酯(178 vs 150 mg/dL)水平较高,高密度脂蛋白胆固醇值略低(48 vs 51 mg/dL)。虽然估计肾小球滤过率(80 vs 76 mL/min/1.73 m2)在糖尿病组和非糖尿病组中相似,但蛋白尿(8.7% vs 3.5%)和微量蛋白尿(29% vs 20%)在糖尿病组中更为普遍。治疗6个月后,使用盲法数据(两组治疗合并)对糖尿病患者的血压控制率(140/90 mm Hg)显示42.8%的糖尿病患者血压水平为130/80 mm Hg。ACCOMPLISH将为优化有糖尿病和无糖尿病的心血管高危高血压患者的治疗策略提供有价值的指导。
The Diabetes Subgroup Baseline Characteristics of the Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) Trial
The Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) trial is the first cardiovascular outcome trial designed to compare initial use of 2 different fixed-dose antihypertensive regimens, benazepril plus hydrochlorothiazide vs benazepril plus amlodipine, on cardiovascular end points in hypertensive patients at high cardiovascular risk secondary to previous major events or presence of diabetes mellitus (DM). Of the 11,464 patients, 60.4% had DM. Compared with non-DM patients, DM patients were less likely to have previous myocardial infarctions (15% vs 37%) or strokes (8% vs 21%). Those with DM were more likely to be female (43% vs 34%), black (15% vs 8%), overweight (body mass index, 32 vs 29 kg/m2). At baseline, DM patients were more likely to have the metabolic syndrome, manifested by higher levels of fasting glucose (145 vs 101 mg/dL) and triglycerides (178 vs 150 mg/dL) and slightly lower high-density lipoprotein cholesterol values (48 vs 51 mg/dL) compared to the non-DM cohort. Although estimated glomerular filtration rate (80 vs 76 mL/min/1.73 m2) was similar in the DM and non-DM groups, presence of both albuminuria (8.7% vs 3.5%) and microalbuminuria (29% vs 20%) were more prevalent in the DM group. After 6 months of treatment, blood pressure control rates (<140/90 mm Hg) using blinded data (both therapeutic groups combined) for DM demonstrated that 42.8% of DM patients had blood pressure levels <130/80 mm Hg. ACCOMPLISH will provide valuable guidance on optimizing treatment strategies in hypertensive patients at high cardiovascular risk with and without DM.