D032 Study population and treatment titration in the International Nifedipine GITS Study Intervention as a goal in hypertension treatment (INSIGHT)

Brown, Margareth; Castaigne, A; Leeuw, Peter W. de; Mancia, G.; Rosenthal, Ted L.; Ruilope, L. M.

doi:10.1016/s0895-7061(97)90991-2

Cited by 5 publications

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“…7 In brief, 6418 patients aged 55 to 80 years from 9 countries, with SBP Ͼ150 mm Hg and DBP Ͼ95 mm Hg or SBP Ͼ160 mm Hg and DBP Ͻ95 mm Hg after 2 to 4 weeks on placebo were randomly assigned to receive GITS 30 mg daily or a combination tablet containing hydrochlorothiazide 25 mg and amiloride 2.5 mg, 1 tablet daily. Treatment was titrated over the next 18 weeks.…”

Section: Methodsmentioning

confidence: 99%

“…6 The International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study was among the first of these studies, initiated in 1994 in high-risk, mainly white hypertensives, and will report its results in June 2000. 7,8 The primary drugs in INSIGHT are a long-acting calcium channel blocker, nifedipine once daily (GITS), and a diuretic combination, hydrochlorothiazide and amiloride. These classes are, arguably, the drugs of choice for older age groups, both for overall antihypertensive efficacy and demonstrated efficacy against placebo in patients with both diastolic hypertension and ISH.…”

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confidence: 99%

“…9 -12 In INSIGHT, an average treated BP of Ͻ140/ 85 mm Hg was achieved, with 68% of patients requiring only 1 drug. 8 The aim of the analyses was to determine, within a study powered to permit multiple comparisons of risk groups, whether BP responsiveness is impaired in any of these risk groups and whether BP control can be achieved in these groups by the addition of extra therapy.…”

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confidence: 99%

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Influence of Diabetes and Type of Hypertension on Response to Antihypertensive Treatment

et al. 2000

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Influence of Diabetes and Type of Hypertension on Response to Antihypertensive Treatment

et al. 2000

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“…Because most groups produced several reports on partially overlapping populations, each group is represented in the Table with its largest contribution. Moreover, the survival analyses of large studies, including the Cornell study, 13 Belgian study, 24 OvA study, 25 ELSA study, 26 and INSIGHT study, 27 are expected in the near future.…”

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confidence: 99%

Prognostic Value of Ambulatory Blood Pressure

Verdecchia¹

2000

Hypertension

467

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Abstract-This article is a critical review of the available evidence on the prognostic value of ambulatory blood pressure (ABP). Several event-based cohort studies have shown that ABP improves cardiovascular risk stratification over and beyond traditional risk factors, including office BP. Most of these studies have been conducted in subjects with essential hypertension who were untreated at the time of execution of ABP monitoring; other studies have been conducted in subjects who were poorly controlled with treatment or in the general population. In these studies, ABP was examined as a continuous variable or with operational risk categories. Cardiovascular risk showed a direct and independent association with the observed ABP (systolic, diastolic, and pulse) and an inverse association with the degree of BP reduction from day to night. Cardiovascular risk was also directly associated with the difference between the observed value of ABP and that predicted from the office BP. White-coat hypertension versus ambulatory hypertension and dippers versus nondippers are 2 classifications based on arbitrary operational risk categories. A blunted or absent BP reduction from day to night, defined with ABP as a continuous variable or with operational thresholds, was also associated with a worse outcome regardless of the average value of ABP during the 24 hours. Overall, these studies indicate that ABP monitoring is particularly valuable to refine cardiovascular risk stratification in untreated subjects with office hypertension and in those with resistant hypertension. Intervention studies targeted at ABP are now needed.

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“…When completed, ongoing studies such as the Office Versus Ambulatory trial in hypertension (OVA) study [41], European Lacidipine Study on Atherosclerosis (ELSA) [42], and International Nifedipine Gastro-Intestinal Therapeutic Systems Study Intervention as a Goal of Hypertension Treatment (INSIGHT) [43] will provide additional information on this subject. …”

Section: Target-organ Damagementioning

confidence: 99%

Treatment of white coat hypertension

Chrysant

2000

Current Science Inc

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White coat hypertension has been defined as the persistent elevation of blood pressure at the clinic or office only. It usually implies that daily ambulatory blood pressure is normal. The accepted cutoff for normal daytime ambulatory blood pressure is 135/85 mm Hg. The prevalence of white coat hypertension is high and varies from 20% to 45%. It appears to be more frequent in women, older patients, and persons with mild hypertension. White coat hypertension should not be confused with the white coat effect. The white coat effect signifies the difference in blood pressure between the office and daytime ambulatory blood pressure and occurs in patients with white coat hypertension as well as in patients with sustained hypertension that is treated or untreated. White coat hypertension is a benign condition, and the incidence of target-organ damage or cardiovascular morbidity and death is not significantly different from that in normotensive persons. Pharmacologic treatment should be withheld; instead, treatment should consist of lifestyle modification, moderate salt restriction, weight reduction, regular exercise, smoking cessation, and correction of glucose and lipid abnormalities. In addition, semiannual or annual follow-up with ambulatory blood pressure monitoring is advised.

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D032 Study population and treatment titration in the International Nifedipine GITS Study Intervention as a goal in hypertension treatment (INSIGHT)

Cited by 5 publications

References 0 publications

Influence of Diabetes and Type of Hypertension on Response to Antihypertensive Treatment

Influence of Diabetes and Type of Hypertension on Response to Antihypertensive Treatment

Prognostic Value of Ambulatory Blood Pressure

Treatment of white coat hypertension

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