HYPERTENSION Flashcards
HOPE-3 trial aim
The goal of the trial was to assess the safety and efficacy of cholesterol lowering, blood pressure (BP) lowering, or both in patients without known cardiovascular disease (CVD), and with an intermediate risk of major CV events (~1% annually)
HOPE-3 trial design
Cholesterol lowering with rosuvastatin 10 mg
BP lowering with candesartan at a dose of 16 mg per day + hydrochlorothiazide (HTCZ) at a dose of 12.5 mg per day
Cholesterol and BP lowering with rosuvastatin + candesartan + HCTZ
HOPE-3 trial outcome
Use of low-dose statin therapy with rosuvastatin 10 mg is superior to placebo in reducing long-term CV events in an intermediate-risk population (CV event rate ~1%/year)
On the other hand, a fixed-dose combination of candesartan 16 mg + HCTZ 12.5 mg daily was not superior to placebo in reducing CV events despite a 6 mm decrease in SBP and a 3 mm decrease in DBP
A fixed-dose combination of all three drugs appeared to have CV benefits that were mostly similar to those observed with rosuvastatin compared with placebo
Trials addressing intensive blood pressure control
ACCORD1 (2010)
SPRINT2 (2015)
STEP3 (2021) trials
STEP trial aim
Determination of appropriate SBP target in a Chinese cohort of older adults with hypertension.
STEP trial design
Chinese patients 60-80 years of age with hypertension randomized to a SBP target of 110 to <130 mm Hg (intensive treatment) and a target of 130 to <150 mm Hg (standard treatment) with a planned follow-up of 4 years
STEP trial outcome
In older adults between the age of 60-80 years, intensive control of SBP between 110 to <130 mm of Hg lead to reduction in incidence of the primary composite outcome
Primary outcomes were:
Stroke (ischemic or hemorrhagic)
ACS (acute MI and hospitalization for unstable angina)
Acute decompensated heart failure
Coronary revascularization
Atrial fibrillation
Cardiovascular death
