Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: The value randomised trial

Use of dihydropyridine calcium channel blockers in the management of hypertension in Eastern Asians: A scientific statement from the Asian Pacific Heart Association

“…LIving with Systolic Hypertension), 33 ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial), 34,35 ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) 36 and VALUE (Valsartan Antihypertensive Long-term Use Evaluation) 37 trials with amlodipine, the STOP-2 (Swedish Trial in Old Patients with hypertension-2) trial with felodipine and isradipine 38 and the INSIGHT (International Nifedipine GITS Study-Intervention as a Goal for Hypertension Therapy) trial with nifedipine GITS. 39 In the amlodipine trials, [33][34][35][36][37] amlodipine reduced systolic blood pressure slightly less than chlothalidone (+1.0 mm Hg) 34 and slightly more than lisinopril in ALLHAT (À1.5 mm Hg), 35 valsartan in VALUE (À2.0 mm Hg), 37 atenolol in ASCOT (À2.8 mm Hg) 36 and hydrochlorothiazide in ACCOMPLISH (À0.9 mm Hg).…”

“…39 In the amlodipine trials, [33][34][35][36][37] amlodipine reduced systolic blood pressure slightly less than chlothalidone (+1.0 mm Hg) 34 and slightly more than lisinopril in ALLHAT (À1.5 mm Hg), 35 valsartan in VALUE (À2.0 mm Hg), 37 atenolol in ASCOT (À2.8 mm Hg) 36 and hydrochlorothiazide in ACCOMPLISH (À0.9 mm Hg). 33 Amlodipine provided similar or increased protection against stroke and myocardial infarction in comparison with chlothalidone (À7 and À2%), 34 lisinopril (À23% (P¼0.003) and À1%), 35 valsartan (À15% (P¼0.08) and À19% (P¼0.02)), 37 atenolol (À23% (P¼0.0003) and À13% (P¼0.05)) 36 and hydrochlorothiazide (À16 and À22% (P¼0.04)). 33 In the STOP-2 trial, felodipine or isradipine was compared with the ACE inhibitor and diuretic/b-blocker groups.…”

“…The risk of stroke was slightly but nonsignificantly lower in the amlodipine group than in the candesartan group (À23%; P¼0.28). If the results of the CASE-J trial were combined with those from the VALUE 37 and IDNT 44 trials that also compared amlodipine with an ARB, amlodipine would be shown to provide superior protection against stroke and myocardial infarction by 16 and 17%, respectively. 8 The NICS-EH (National Intervention Cooperative Study in Elderly Hypertensives) trial included only 414 hypertensive patients, compared two outdated antihypertensive drugs (sustained-release nicardipine vs. trichlomethiazide), had only a total of 39 events during 5 years of follow-up, and was thus inadequately powered.…”

“…38 Syst-China (Systolic Hypertension in China trial); 1,2 VALUE (Valsartan Antihypertensive Long-term Use Evaluation). 37 …”

Treatment patterns of hypertension and dyslipidaemia in hypertensive patients at higher and lower risk of cardiovascular disease in primary care in the United Kingdom

“…19 The benefits of prompt and aggressive control of blood pressure (BP) have also been demonstrated in the BP-lowering arm of ASCOT (ASCOT-BPLA) 21 and the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial. 22 In patients at risk of CVD with concurrent hypertension and dyslipidaemia, it is important that both conditions should be treated concomitantly and aggressively. However, little is known about the patterns of treatment of hypertension and dyslipidaemia in the UK primary care setting, particularly in patients at a high risk of CVD.…”