Effect of angiotensin receptor blockade and antihypertensive drugs on diastolic function in patients with hypertension and diastolic dysfunction: a randomised trial

Solomon, Scott D.; Janardhanan, Rajesh; Verma, Anil; Bourgoun, Mikhail; Daley, William; Purkayastha, Das; Lacourcière, Yves; Hippler, Stephen; Fields, Harold; Naqvi, Tasneem Z.; Mulvagh, Sharon L.; Arnold, J. Malcolm O.; Thomas, James D.; Zile, Michael R.; Aurigemma, Gerard P.

doi:10.1016/s0140-6736(07)60980-5

Cited by 307 publications

(204 citation statements)

References 38 publications

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“…First, the reduction in the systolic blood pressure, in itself, may be associated with the improvement in left ventricular diastolic function as shown in VALIDD trial. 4,7,[13][14][15][16] In this study, the greater reduction in systolic blood pressure was associated with the greater increase in the e¢ velocity. Second, left ventricular systolic load may be reduced by attenuating the wave reflection.…”

Section: Impact Of Ccb On Diastolic Functionsupporting

confidence: 46%

“…5,6 In the Valsartan in Diastolic Dysfunction (VALIDD) trial, however, the inhibition of the renin-angiotensin system failed to show an additional benefit after the change in diastolic relaxation velocity in comparison with the antihypertensive drugs of non-rennin-angiotensin system inhibition. 7 This study showed that lowering blood pressure (BP) improves the diastolic function irrespective of the type of antihypertensive agent used.…”

Section: Introductionmentioning

confidence: 99%

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Impact of azelnidipine treatment on left ventricular diastolic performance in patients with hypertension and mild diastolic dysfunction: multi-center study with echocardiography

et al. 2009

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, for the Clinical impact of Azelnidipine on Left VentricuLar diastolic function and OutComes in patients with hypertension (CALVLOC) trial investigators 7We investigated the impact of lowering blood pressure (BP) with azelnidipine, a newly developed calcium channel blocker, generation on the left ventricular (LV) diastolic function and LV filling pressure by assessing non-invasive indices derived from echo Doppler study. This study evaluated 232 hypertensive patients with diastolic dysfunction. This study had two groups: (1) in which azelnidipine was administered to patients as a first-line therapy, and (2) in which amlodipine was converted to azelnidipine. Early diastolic mitral annulus velocity (e¢, cm s À1 ), the ratio of peak E velocity to e¢ velocity (E/e¢ ratio) and level of brain natriuretic peptide (BNP) were measured before and, an average of, 8 months after azelnidipine treatment. In the first-line azelnidipine group, the systolic and diastolic BP reduced by 26 and 11 mm Hg, respectively. The e¢ increased, and E/e¢ ratio and BNP level decreased significantly. In the converted-from-amlodipine group, the systolic and diastolic BP decreased by 14 and 6 mmHg, respectively. The e¢ velocity increased, but the E/e¢ ratio and BNP level did not change. In both groups, azelnidipine lowered BP and improved LV diastolic function (an increase in the e¢ velocity). Possible reduction in LV filling pressure (a decrease in the E/e¢ ratio and BNP level) is observed only in the first-line azelnidipine group.

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Section: Impact Of Ccb On Diastolic Functionsupporting

confidence: 46%

Section: Introductionmentioning

confidence: 99%

Impact of azelnidipine treatment on left ventricular diastolic performance in patients with hypertension and mild diastolic dysfunction: multi-center study with echocardiography

et al. 2009

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“…Among these 59 surrogate endpoint trials that had a subsequent clinical endpoint trial, in 24 cases the clinical endpoint trial results validated the positive surrogate trials, while in 20 the subsequent clinical endpoint trial was negative (Table 3). 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50 A negative surrogate endpoint trial was less likely to be followed by a positive outcome trial and we identified only 3 such examples ( P =0.02, Figure 2). …”

Section: Resultsmentioning

confidence: 99%

Two Decades of Cardiovascular Trials With Primary Surrogate Endpoints: 1990–2011

Bikdeli

Punnanithinont

Akram

et al. 2017

JAHA

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BackgroundSurrogate endpoint trials test strategies more efficiently but are accompanied by uncertainty about the relationship between changes in surrogate markers and clinical outcomes.Methods and ResultsWe identified cardiovascular trials with primary surrogate endpoints published in the New England Journal of Medicine, Lancet, and JAMA: Journal of the American Medical Association from 1990 to 2011 and determined the trends in publication of surrogate endpoint trials and the success of the trials in meeting their primary endpoints. We tracked for publication of clinical outcome trials on the interventions tested in surrogate trials. We screened 3016 articles and identified 220 surrogate endpoint trials. From the total of 220 surrogate trials, 157 (71.4%) were positive for their primary endpoint. Only 59 (26.8%) surrogate trials had a subsequent clinical outcomes trial. Among these 59 trials, 24 outcomes trial results validated the positive surrogates, whereas 20 subsequent outcome trials were negative following positive results on a surrogate. We identified only 3 examples in which the surrogate trial was negative but a subsequent outcomes trial was conducted and showed benefit. Findings were consistent in a sample cohort of 383 screened articles inclusive of 37 surrogate endpoint trials from 6 other high‐impact journals.ConclusionsAlthough cardiovascular surrogate outcomes trials frequently show superiority of the tested intervention, they are infrequently followed by a prominent outcomes trial. When there was a high‐profile clinical outcomes study, nearly half of the positive surrogate trials were not validated. Cardiovascular surrogate outcome trials may be more appropriate for excluding benefit from the patient perspective than for identifying it.

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“…On the other hand, the VALIDD study 178 (VAL sartan In Diastolic Dysfunction study) demonstrated that blood pressure lowering in patients with hypertension and LV DD, either with valsartan or a regimen including beta blockers (BB), calcium channel blockers (CCB), diuretics and a blockers, elicited a similar reduction in blood pressure and improvement in diastolic relaxation.…”

Section: Possible Therapiesmentioning

confidence: 99%

Echocardiographic evaluation of diastolic heart failure

Thomas

2010

Australas J Ultrason Med

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Effect of angiotensin receptor blockade and antihypertensive drugs on diastolic function in patients with hypertension and diastolic dysfunction: a randomised trial

Cited by 307 publications

References 38 publications

Impact of azelnidipine treatment on left ventricular diastolic performance in patients with hypertension and mild diastolic dysfunction: multi-center study with echocardiography

Impact of azelnidipine treatment on left ventricular diastolic performance in patients with hypertension and mild diastolic dysfunction: multi-center study with echocardiography

Two Decades of Cardiovascular Trials With Primary Surrogate Endpoints: 1990–2011

Echocardiographic evaluation of diastolic heart failure

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