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Influence of age, sex and blood pressure on the principal endpoints of the Nordic Diltiazem (NORDIL) Study
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- Kjeldsen, SE (författare)
- Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden
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- Hedner, T (författare)
- Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden
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- Syvertsen, JO (författare)
- Univ Oslo, Ullevaal Hosp, Dept Cardiol, N-0407 Oslo, Norway Univ Michigan, Div Hypertens, Ann Arbor, MI 48109 USA Sahlgrens Univ Hosp, Dept Clin Pharmacol, S-41345 Gothenburg, Sweden Varna Med Ctr, Moss, Norway Haukeland Univ Hosp, Dept Cardiol, N-5021 Bergen, Norway Univ Uppsala Hosp, Dept Geriatr, S-75185 Uppsala, Sweden Lund Univ, Dept Stat, S-22363 Lund, Sweden Univ Umea Hosp, Dept Publ Hlth & Clin Med, S-90185 Umea, Sweden Karolinska Univ Hosp, Dept Med, Stockholm, Sweden Ostra Univ Hosp, Dept Med, Gothenburg, Sweden Linkoping Univ Hosp, Dept Endocrinol, S-58185 Linkoping, Sweden
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- Ovid Technologies (Wolters Kluwer Health), 2002
- 2002
- Engelska.
- Ingår i: Journal of Hypertension. - : Ovid Technologies (Wolters Kluwer Health). - 0263-6352 .- 1473-5598. ; 20:6, s. 1231-1237
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Background The aim of the Nordic Diltiazem (NORDIL) Study was to compare patients with essential hypertension receiving calcium-antagonist-based treatment with diltiazem and similar patients receiving conventional diuretic/beta-blocker-based treatment, with respect to cardiovascular morbidity and mortality. Objective To assess the influence of age, sex, severity of hypertension and heart rate on treatment effects, in a sub-analysis. Methods The NORDIL study was prospective, randomized, open and endpoint-blinded. It enrolled, at health centres in Norway and Sweden, 10881 patients aged 50-74 years who had diastolic blood pressure (DBP) of 100 mmHg or more. Systolic blood pressure (SBP) and DBP were decreased by 20.3/18.7 mmHg in the diltiazem group and by 23.3/18.7 mmHg in the diuretic/beta-blocker group - a significant difference in SBP (P < 0.001). Results The incidence of the primary endpoint - a composite of cardiovascular death, cerebral stroke and myocardial infarction - was similar for the two treatments. Fatal and non-fatal stroke occurred in 159 patients in the diltiazem group and in 196 patients in the conventional treatment group [relative risk MR) 0.80, 95% confidence interval (CO 0.65 to 0.99, P = 0.0401, whereas there was a non-significant inverse tendency with respect to all myocardial infarction. Three Were significantly fewer cerebral strokes ip atiepts receiving diltiazem in the subgroups with baseline SBP > 170 mmHg (n = 5420, RR 0.75,95% CI 0.58 to 0.98, P = 0.032), DBP 105 mmHg (n = 5881, RR 0.74,95% Cl 0.57 to 0.97, P = 0.030) and pulse pressure greater than or equal to 66 mmHg (n = 5461, RR 0.76, 95% Cl 0.58 to 0.99, P = 0.041), and more myocardial infarctions in those with heart rate less than 74 beats/min (n = 5303, RR 1.13, 95% Cl 1.01 to 1.87, P = 0.040). However, the tendencies for fewer strokes and greater incidence of myocardial infarction were present across subgroups when results were analysed for age, sex, severity of hypertension and heart rate, and treatment-subgroup interaction analyses were not statistically significant. Conclusions Compared with a conventional diuretic/beta-blocker-based anti hypertensive regimen, there were additional 25% reductions in stroke in the diltiazem-treated patients with blood pressure or pulse pressure greater than the medians, and an increase in myocardial infarction in those with heart rate less than the median. Such findings may be attributable to chance, but the consistency of, in particular, the stroke findings may also suggest an ability of diltiazem, beyond conventional treatment, to prevent cerebral stroke in hypertensive patients with the greatest cardiovascular risk. (C) 2002 Lippincott Williams Wilkins.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- blood pressure
- diltiazem
- hypertension
- myocardial infarction
- stroke
- NATURAL SCIENCES
- NATURVETENSKAP
- myocardial infarction
- hypertension
- blood pressure
- diltiazem
- stroke
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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- Kjeldsen, SE
- Hedner, T
- Syvertsen, JO
- Lund-Johansen, P
- Hansson, L
- Lanke, Jan
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- Lindholm, LH
- de Faire, U
- Dahlof, B
- Karlberg, BE
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