新近循证医学对JNC8指南的影响课件.ppt

Tight BP control reduces the prevalence of CV events? Randomised, open-label trial of patients without diabetes and SBP ≥150 mmHg Patients randomised to usual BP control (SBP 140 mmHg) or tight BP control SBP (130 mmHg) Meta-Analysis: The Beta Blocker Atenolol is Less Effective than Non-Beta Blocker Treatments Effects of the Combination of Olmesartan and Amlodipine on Systolic Blood Pressure HOPE: Relative Risk Reduction Ramipril vs Placebo Resistant Hypertension:Spironolactone Efficacy Darusentan: An Endothelin Antagonist Change from Baseline in Sitting Systolic Blood Pressure Systolic BP Reduction and CVD Mortality Tight BP control reduces the prevalence of LVH Randomised, open-label trial of 1111 patients without diabetes and SBP ≥150 mmHg Patients were randomised (1:1) to usual BP control (SBP 140 mmHg) or tight BP control SBP (130 mmHg) SBP/DBP over time Primary endpoint and individual components Mean Reduction in SeSBP: Patients with DiabetesWeek 8 LOCF in Patients With and Without Diabetes Edema Data with AZOR? (amlodipine and olmesartan medoxomil)–Proactive Evaluation The incidence of edema was significantly reduced when 20 mg or 40 mg of olmesartan medoxomil was added to the 10 mg amlodipine dose A reduction in the incidence of edema was not observed with AZOR(amlodipine and olmesartan medoxomil) 5/20 mg or 5/40 mg compared to amlodipine 5 mg monotherapy Edema is a known, dose-dependent adverse event of amlodipine but not of olmesartan medoxomil Resistant Hypertension:Spironolactone Safety Darusentan in Resistant Hypertension:Ambulatory SBP Over 24 Hours * * * * * * Ambulatory BP monitoring – measurements taken every 20 minutes over 24 hours Only patients with ambulatory data that met pre-specified QC criteria were included in analyses * The percentages of patients who achieved the BP goal of 140/90 was statistically greater in all BENICAR? (olmesartan medoxomil) treatment arms compared to placebo. 39% and 54.8% of those receiving BENICAR (olm