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OR-29: The value trial : long-term blood pressure trends in 13,449 patients with hypertension and high cardiovascular risk

Julius, Stevo ; Kjeldsen, Sverre E. ; Brunner, Hans ; Hansson, Lennart ; Henis, Marc ; Ekman, Steffan ; Laragh, John ; McInnes, Gordon ; Smith, Beverly ; Weber, Michael ; Zanchetti, Alberto

In: American Journal of Hypertension, 2003, vol. 16, no. S1, p. 12A-12A

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    Title
    • OR-29: The value trial
      long-term blood pressure trends in 13,449 patients with hypertension and high cardiovascular risk
    Author
    • Julius, Stevo. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Kjeldsen, Sverre E.. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Brunner, Hans. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Hansson, Lennart. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Henis, Marc. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Ekman, Steffan. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Laragh, John. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • McInnes, Gordon. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Smith, Beverly. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Weber, Michael. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    • Zanchetti, Alberto. Hypertension/Internal Medicine, University of Michigan Hospital, Ann Arbor, MI; Cardiovascular Clinical Research, Novartis Pharmaceuticals Corporation, Summit, NJ; Cardiovascular Clinical Research, Novartis Pharma AG, Basel, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:290160
    Summary
    Purpose: The VALUE Trial compares cardiovascular outcomes in 15,314 eligible patients from 31 countries randomized to valsartan or amlodipine-based treatment. Methods: The blood pressure (BP) trends are analyzed in 13,449 patients with baseline and 24 months data, and in 12,570 patients with baseline and 30 months data. Results: Ninety two % received antihypertensive therapy prior to enrollment. The (entry) BP in treated patients was 153.5/ 86.9 mmHg compared to 168.1.8/95.3 mmHg in untreated patients. After sixth months both groups had indistinguishable BP values. At 12 months the BP fell to 141.2/ 82.9 mmHg, at 24 month to 139.1/79.8 mmHg (p <0.0001 vs 12 months), and to 138.1/79.0 mmHg at 30 months (p< 0.0001 vs 24 months). Compared to baseline (21.7%) the systolic control BP (<140 mmHg) increased to 59.5% at 24 months and 62.2% at 30 months. Similarly, the diastolic control BP (<90 mmHg) increased from 53.7% at baseline to 88.6% at 24 months and 90.0% at 30 months, and combined control (<140 and <90 mmHg) increased from 18.9% at baseline to 57.6% at 24 months and 60.5% at 30 months. All proportions at 24 and 30 months vs baseline for diastolic, systolic and combined control BP are highly significant (p<0.0001). At 24 months 87.7% of all patients received randomized therapy: monotherapy = 39.7%, added hydrochlorothiazide= 46.0%, additional drugs permitted by the protocol= 15.9%. Conclusion: The VALUE Trial is executed in regular clinical settings. The achieved BP control in this study is better than in any published large-scale trial. Our results demonstrate that when explicit BP goal is set and a treatment algorithm is provided, the physicians achieve much better control rates than in their regular practice