解读最化新欧洲高血压指南ppt课件.ppt

* * 首先络活喜组降压幅度大，而且可以长期持久控制血压： 我们知道如果评价一个降压药物降压疗效，上万例、数年观察的大型临床研究结果的证实力度明显要强于几百例的小型研究， ALLHAT 研究是全世界最大的高血压研究，VALUE是CCB和ARB头对头的比较研究，ASCOT研究是欧洲最大的高血压研究，这三个研究均采用络活喜做为研究用药。通过这三个研究我们可以看出，络活喜组均能取得很好的降压效果，降压幅度都很大！ALLHAT研究基线血压是146.2/83.9mmHg, 络活喜组SBP和DBP分别降低了11.5/9.3mmHg；VALEU研究中基线血压是154.8/87.6mmHg, 络活喜组SBP和DBP分别降低了17.3/9.9mmHg；ASCOT-BPLA研究中基线血压是164.1/94.8mmHg,络活喜组降低SBP和DBP分别降低了17.3/9.9mmHg。同时由于三个研究观察时间均长达4－6年，因此也充分反应络活喜可以长期持久控制血压。此外这三个研究显示络活喜降压效果优于ACEI， ARB及B阻滞剂，并且能够长期持久控制血压，从而减少心脑血管事件。 * * * * * * * Slide 10 ELITE II enrolled patients 60 years of age or older with mild and moderate to severe heart failure (NYHA Class II–IV and ejection fraction 40%). Most patients were required to be na?ve to ACE inhibitors and A II antagonists, although some patients were eligible if their exposure to such treatment was limited to seven days or less within the three months before randomization. After one to 28 days of single-blind placebo run-in, eligible patients were randomized to 48 weeks of double-blind therapy with captopril (target dose 50 mg three times daily; n=1574) or losartan (target dose 50 mg once daily; n=1578). The primary endpoint was all-cause mortality; the secondary endpoint was the composite of sudden cardiac death and/or resuscitated cardiac arrest. Other endpoints included all-cause mortality/hospitalizations, safety and tolerability, mortality by cause, NYHA functional status, and quality of life.26 This event-driven trial was designed with a 90% power to detect a relative 25% difference in total mortality between treatments. Because the protocol specified a significance level of 5%, the critical p value for the primary endpoint of all-cause mortality was adjusted to 0.043, with a confidence interval of 95.7%, to maintain the overall significance level at 5% and to allow the independent Data and Safety Monitoring Committee to perform several interim analyses.26 When ELITE was designed with renal dysfunction as the primary endpoint, captopril was chosen as t