Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA.
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| Title: | Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA. |
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| Authors: | Poulter, Neil R., Wedel, Hans, Dahlöf, Björn, Sever, Peter S., Beevers, D. Gareth, Caulfield, Mark, Kjeldsen, Sverre E., Kristinsson, Arni, McInnes, Gordon T., Mehlsen, Jesper, Nieminen, Markku, O'Brien, Eoin, Östergren, Jan, Pocock, Stuart |
| Source: | Lancet. 9/10/2005, Vol. 366 Issue 9489, p907-913. 7p. 4 Charts, 2 Graphs. |
| Subjects: | Blood pressure, Therapeutics, Hypertension, Antihypertensive agents, Cerebrovascular disease risk factors, Coronary heart disease risk factors, Cardiovascular diseases risk factors, Cardiovascular pharmacology, Research methodology |
| Abstract: | Summary Background Results of the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) show significantly lower rates of coronary and stroke events in individuals allocated an amlodipine-based combination drug regimen than in those allocated an atenolol-based combination drug regimen (HR 0·86 and 0·77, respectively). Our aim was to assess to what extent these differences were due to significant differences in blood pressures and in other variables noted after randomisation. Methods We used data from ASCOT-BPLA (n=19 257) and compared differences in accumulated mean blood pressure levels at sequential times in the trial with sequential differences in coronary and stroke events. Serial mean matching for differences in systolic blood pressure was used to adjust HRs for differences in these events. We used an updated Cox-regression model to assess the effects of differences in accumulated mean levels of various measures of blood pressure, serum HDL-cholesterol, triglycerides and potassium, fasting blood glucose, heart rate, and bodyweight on differences in event rates. Findings We noted no temporal link between size of differences in blood pressure and different event rates. Serial mean matching for differences in systolic blood-pressure attenuated HRs for coronary and stroke events to a similar extent as did adjustments for systolic blood-pressure differences in Cox-regression analyses. HRs for coronary events and stroke adjusted for blood pressure rose from 0·86 (0·77-0·96) to 0·88 (0·79-0·98) and from 0·77 (0·66-0·89) to 0·83 (0·72-0·96), respectively. Multivariate adjustment gave HRs of 0·94 (0·81-1·08) for coronary events (HDL cholesterol being the largest contributor) and 0·87 (0·73-1·05) for stroke events. Interpretation Multivariate adjustment accounted for about half of the differences in coronary events and for about 40% of the differences in stroke events between the treatment regimens tested in ASCOT-BPLA, but residual differences were no longer significant. These residual differences could indicate inadequate statistical adjustment, but it remains possible that differential effects of the two treatment regimens on other variables also contributed to the different rates noted, particularly for stroke. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 18170941 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Poulter%2C+Neil+R%2E%22">Poulter, Neil R.</searchLink><br /><searchLink fieldCode="AR" term="%22Wedel%2C+Hans%22">Wedel, Hans</searchLink><br /><searchLink fieldCode="AR" term="%22Dahlöf%2C+Björn%22">Dahlöf, Björn</searchLink><br /><searchLink fieldCode="AR" term="%22Sever%2C+Peter+S%2E%22">Sever, Peter S.</searchLink><br /><searchLink fieldCode="AR" term="%22Beevers%2C+D%2E+Gareth%22">Beevers, D. Gareth</searchLink><br /><searchLink fieldCode="AR" term="%22Caulfield%2C+Mark%22">Caulfield, Mark</searchLink><br /><searchLink fieldCode="AR" term="%22Kjeldsen%2C+Sverre+E%2E%22">Kjeldsen, Sverre E.</searchLink><br /><searchLink fieldCode="AR" term="%22Kristinsson%2C+Arni%22">Kristinsson, Arni</searchLink><br /><searchLink fieldCode="AR" term="%22McInnes%2C+Gordon+T%2E%22">McInnes, Gordon T.</searchLink><br /><searchLink fieldCode="AR" term="%22Mehlsen%2C+Jesper%22">Mehlsen, Jesper</searchLink><br /><searchLink fieldCode="AR" term="%22Nieminen%2C+Markku%22">Nieminen, Markku</searchLink><br /><searchLink fieldCode="AR" term="%22O'Brien%2C+Eoin%22">O'Brien, Eoin</searchLink><br /><searchLink fieldCode="AR" term="%22Östergren%2C+Jan%22">Östergren, Jan</searchLink><br /><searchLink fieldCode="AR" term="%22Pocock%2C+Stuart%22">Pocock, Stuart</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 9/10/2005, Vol. 366 Issue 9489, p907-913. 7p. 4 Charts, 2 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Blood+pressure%22">Blood pressure</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink><br /><searchLink fieldCode="DE" term="%22Hypertension%22">Hypertension</searchLink><br /><searchLink fieldCode="DE" term="%22Antihypertensive+agents%22">Antihypertensive agents</searchLink><br /><searchLink fieldCode="DE" term="%22Cerebrovascular+disease+risk+factors%22">Cerebrovascular disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Coronary+heart+disease+risk+factors%22">Coronary heart disease risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiovascular+diseases+risk+factors%22">Cardiovascular diseases risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiovascular+pharmacology%22">Cardiovascular pharmacology</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Summary Background Results of the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) show significantly lower rates of coronary and stroke events in individuals allocated an amlodipine-based combination drug regimen than in those allocated an atenolol-based combination drug regimen (HR 0·86 and 0·77, respectively). Our aim was to assess to what extent these differences were due to significant differences in blood pressures and in other variables noted after randomisation. Methods We used data from ASCOT-BPLA (n=19 257) and compared differences in accumulated mean blood pressure levels at sequential times in the trial with sequential differences in coronary and stroke events. Serial mean matching for differences in systolic blood pressure was used to adjust HRs for differences in these events. We used an updated Cox-regression model to assess the effects of differences in accumulated mean levels of various measures of blood pressure, serum HDL-cholesterol, triglycerides and potassium, fasting blood glucose, heart rate, and bodyweight on differences in event rates. Findings We noted no temporal link between size of differences in blood pressure and different event rates. Serial mean matching for differences in systolic blood-pressure attenuated HRs for coronary and stroke events to a similar extent as did adjustments for systolic blood-pressure differences in Cox-regression analyses. HRs for coronary events and stroke adjusted for blood pressure rose from 0·86 (0·77-0·96) to 0·88 (0·79-0·98) and from 0·77 (0·66-0·89) to 0·83 (0·72-0·96), respectively. Multivariate adjustment gave HRs of 0·94 (0·81-1·08) for coronary events (HDL cholesterol being the largest contributor) and 0·87 (0·73-1·05) for stroke events. Interpretation Multivariate adjustment accounted for about half of the differences in coronary events and for about 40% of the differences in stroke events between the treatment regimens tested in ASCOT-BPLA, but residual differences were no longer significant. These residual differences could indicate inadequate statistical adjustment, but it remains possible that differential effects of the two treatment regimens on other variables also contributed to the different rates noted, particularly for stroke. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1016/S0140-6736(05)67186-3 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 7 StartPage: 907 Subjects: – SubjectFull: Blood pressure Type: general – SubjectFull: Therapeutics Type: general – SubjectFull: Hypertension Type: general – SubjectFull: Antihypertensive agents Type: general – SubjectFull: Cerebrovascular disease risk factors Type: general – SubjectFull: Coronary heart disease risk factors Type: general – SubjectFull: Cardiovascular diseases risk factors Type: general – SubjectFull: Cardiovascular pharmacology Type: general – SubjectFull: Research methodology Type: general Titles: – TitleFull: Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Poulter, Neil R. – PersonEntity: Name: NameFull: Wedel, Hans – PersonEntity: Name: NameFull: Dahlöf, Björn – PersonEntity: Name: NameFull: Sever, Peter S. – PersonEntity: Name: NameFull: Beevers, D. Gareth – PersonEntity: Name: NameFull: Caulfield, Mark – PersonEntity: Name: NameFull: Kjeldsen, Sverre E. – PersonEntity: Name: NameFull: Kristinsson, Arni – PersonEntity: Name: NameFull: McInnes, Gordon T. – PersonEntity: Name: NameFull: Mehlsen, Jesper – PersonEntity: Name: NameFull: Nieminen, Markku – PersonEntity: Name: NameFull: O'Brien, Eoin – PersonEntity: Name: NameFull: Östergren, Jan – PersonEntity: Name: NameFull: Pocock, Stuart IsPartOfRelationships: – BibEntity: Dates: – D: 10 M: 09 Text: 9/10/2005 Type: published Y: 2005 Identifiers: – Type: issn-print Value: 01406736 Numbering: – Type: volume Value: 366 – Type: issue Value: 9489 Titles: – TitleFull: Lancet Type: main |
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