Trial | Year | Type of Patients (n) | Years of Follow-up (n) | Drugs Compared | Entry BP (mm Hg) | BP Difference During Study | P | Primary Endpoint | Relative Risk | 95% CI | Other Significant Outcome Differences | P |
---|---|---|---|---|---|---|---|---|---|---|---|---|
UKPDS7 | 1998 | Hypertensive (n = 758) | 9 | Captopril vs atenolol | 159/93 | NS | NA | Cli diab event | 1.1 | 0.86–1.41 | None | NS |
Diabetes death | 1.27 | 0.82–1.97 | NS | |||||||||
Total mortality | 1.14 | 0.81–1.61 | NS | |||||||||
CAPPP8 | 1999 | Hypertensive (n = 10,985) | 6.1 | Captopril vs DIUs/β-blockers | 162/100 | Captopril; BP higher 2/2 | NA | MI, stroke, CV death | 1.05 | 0.90–1.22 | 43% higher incidence of stroke in captopril group | .004 |
STOP-29 | 1999 | Hypertensive (n = 4418) | 4.6 | ACEIs vs conventional | 194/98 | NS | NA | CV death | 1.01 | 0.84–1.22 | None | NS |
LIFE10 | 2002 | Hypertensive (n = 9193) | 4.8 | Losartan vs atenolol | 174/98 | Losartan; SBP lower 1.1 | .017 | CV death, stroke, MI† | 0.87 | 0.77–0.98 | 25% stroke reduction in losartan group | .001 |
ALLHAT11 | 2002/2003 | Hypertensive (n = 24,309) | 4.9 | Chlorthalidone vs lisinopril | 146/84 | Lisinopril SBP higher 2 | <.001 | Fatal CHD, nonfatal MI | 0.99 | 0.91–1.08 | Lisinopril group: 15% higher stroke | .02 |
19% higher HF | <.001 | |||||||||||
ANBP-212 | 2003 | (n = 26,083) | 4.1 | ACEIs vs DIUs | 168/91 | NS | NA | CVS event total mortality‡ | 0.89 | 0.79–1.00 | In men, RR = 0.83 | .02 |
In women, RR = 0.98; | .98 | |||||||||||
JMIC-B13 | 2004 | Hypertensive (n = 1650) | 3 | ACEIs vs nifedipine | 145/82 | ACEI BP higher 4/1 | <.01 | Cardiac event | 1.05 | 0.81–1.37 | ACEI group coronary lumen narrowed | NS |
VALUE14 | 2004 | Hypertensive (n = 15,245) | 4.2 | Amlodipine vs valsartan | 155/88 | Valsartan BP higher 2.1/1.7 | <.0001 | CV event | 1.04 | 0.94–1.15 | Valsartan group 19% higher MI | .02 |
* Trials should show (1) no significant difference in primary endpoint in most studies and (2) the group with lower blood pressure had lower adverse clinical outcome regardless of strategy.
† P = .021.
‡ P = .05.
Cli diab, clinical diabetes; DIUs, diuretics; ACEIs, angiotensin-converting enzyme inhibitors; NS, not significant; NA, not available; BP, blood pressure; MI, myocardial infarction; CV, cardiovascular; SBP, systolic blood pressure; CHD: coronary heart disease; UKPDS, United Kingdom Prospective Diabetes Study Group; CAPPP, Captopril Prevention Project; STOP-2, Swedish Trial in Old Patients with Hypertension 2; LIFE, Losartan Intervention For Endpoint Reduction in Hypertension Study; ALLHAT, Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; ANBP-2, Second Australian National Blood Pressure Study Group; JMIC-B, Japan Multicenter Investigation for Cardiovascular Diseases-B randomized trial; VALUE, Valsartan Antihypertensive Long-Term Use Evaluation; RR, relative risk; HF, heart failure.