HEALTH: BENEFITS OF NEW HYPERTENSION STRATEGY CITEDMANILA, January 21, 2005 (STAR) A panel of international experts has halted a major clinical trial on hypertension because of significant benefits shown with a new hypertension treatment strategy. Experts believe this could have major implications on the treatment of millions of patients worldwide.
The blood pressure arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT)1 has been stopped early by the ASCOT Steering Committee because of substantial benefits in favor of the amlodipine/perindopril based treatment strategy.
ASCOT is a major multinational trial involving over 19,000 hypertensive patients that compares the effectiveness of two different treatment strategies in reducing cardiovascular events including heart attacks and stroke.
The new treatment strategy (the calcium channel blocker, amlodipine, and the angiotensin converting enzyme inhibitor, perindopril) was found to offer significant advantages over the older treatment strategy (the beta blocker, atenolol and the thiazide diuretic, bendroflumethiazide), to such an extent that the trial was stopped early.
"The results of the ASCOT trial have been long-awaited," said Prof. Peter Sever of Imperial College of London, co-chairman of the steering committee. "Stopping a trial early because of important cardiovascular benefits to those patients receiving amlodipine and perindopril is a very exciting outcome, and suggests that we need to rethink our hypertension treatment strategies using these newer more effective treatments."
The implications on the use of the amlodipine/perindopril combination in terms of reduction in cardiovascular events are huge. The traditional treatment regime of a beta-blocker and diuretic is very widely used, meaning that potentially million of patients worldwide could benefit from the positive effects of this new combination of treatments.
These new results show that using amlodipine together with perindopril can produce significant benefits for patients. There is evidence that amlodipine and perindopril can give benefits when used separately. For example, perindopril was shown to be effective in the EUROPA trial, which demonstrated a risk reduction of 20 percent in the combination of cardiovascular death, myocardial infarction and cardiac arrest in a wide range of patients with CHD.
Furthermore, results were similar in patients with or without hypertension, with a significant risk reduction of fatal and non-fatal MI of 23.9 percent and a significant risk reduction in heart failure of 39.2 percent. It now seems that ASCOT will extend these exciting benefits to all patients with hypertension.
Until complete data are available, doctors are advised to maintain their patients on existing medications for hypertension to ensure that their blood pressure remains controlled. If patients are concerned about their current therapy, they are advised to consult their GP. Sudden withdrawal of any treatment regimen could be harmful.
Reported by: Sol Jose Vanzi
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