The CREATE-ECLA Randomized Controlled TrialThe CREATE-ECLA Trial Group Investigators* See also pp 427 and 489.

EudraCT Number: 2010-019986-27.

Abstract-High-altitude tourism is increasingly frequent, involving also subjects with manifest or subclinical coronary artery disease. Little is known, however, on the effects of altitude exposure on factors affecting coronary perfusion. The aim of our study was to assess myocardial oxygen supply/demand ratio in healthy subjects during acute exposure at high altitude and to evaluate the effect of acetazolamide on this parameter. Forty-four subjects (21 men, age range: 24-59 years) were randomized to double-blind acetazolamide 250 mg bid or placebo. Subendocardial viability ratio and oxygen supply/demand ratio were estimated on carotid artery by means of a validated PulsePen tonometer, at sea level, before and after treatment, and after acute and more prolonged exposure to high altitude (4559 m). On arrival at high altitude, subendocardial viability ratio was reduced in both placebo (from 1.63±0.

Background: Pulse wave velocity (PWV) reflects arterial stiffness and is an independent predictor of cardiovascular mortality and morbidity. It is important to determine the effect dual therapy has on both BP and PWV. Methods: A quasi-experimental study was performed in patients with grade 1 and 2 primary hypertension (HTN). Patients received the combination amlodipine/fimasartan (5 mg/60 mg/day) for 8 weeks. Anthropometric and hemodynamic measurements were made after a 2-week washout period and at week 8 of treatment. The brachial-ankle pulse wave velocity (baPWV), SBP, DBP, Pulse pressure (PP), central systolic blood pressure (cSBP) and the augmentation index normalized to 75 bpm (pAIx75) were measured. Results: We included 42 patients (14 women) aged 56 ± 16 years. We observed a decrease in baVOP, 17.99 ± 2.80 m/s vs 16.14 ± 2.36 m/s, (p < 0.001); SBP 160 ± 18 mmHg vs 138 ± 14 mmHg (p < 0.001); DBP 96 ± 14 mmHg vs 82 ± 10 mmHg, (p < 0.001); PP 63 ± 18 mmHg vs 56 ± 14 mmHg, (p < 0.001); AIx75 85 ± 9% vs 80 ± 10%, (p = 0.002); and cSBP 151 ± 18 mmHg vs 128 ± 15 mmHg (p < 0.001). Before the treatment 71% patients had arterial stiffness and after the treatment only 33% of the patients had it, the BP goal of <130/80 was achieved in only 16%. Conclusion: The short term dual therapy with amlodipine/fimasartan significantly decreased baPWV, cSBP, PP, SBP, DBP and pAIx75. Only 16% of the patients achieved the BP goal with this treatment.

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