Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding. ASCOT-BPLA is one of the first major studies to compare combination antihypertensive regimens. Although the trial design started patients with. ASCOT-BPLA Trial Overview. ♢ a multi-center randomized placebo-controlled trial to determine effects of amlodipine +/- perindopril vs atenolol.
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Leave This Blank Too: Overall, this investigation found that correcting for these variables reduced the differences by about half for coronary events and by just under half for stroke events, and that neither were statistically significant after the correction.
The main objective of hypertension treatment is to attain and maintain goal BP. However, the size of benefit was significantly less than predicted compared to previous observational studies . The lack of statistical significance may have been due to early trial termination, as the trial did not meet the pre-specified number of primary events of For more detail, read on. For a given reduction in blood pressure, some suggested that newer agents would confer advantages over diuretics and beta blockers.
This is to be expected due to the peripheral vasodilation effects of Amlodipine and Perindopril compared to Atenolol and Bendroflumethiazide. However, the trial was underpowered as it was stopped early due to a significant reduction in all cause-mortality in the amlodipine and perindopril arm.
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ASCOT – BPLA – Prescribing Advice for GPs
Navigation menu Personal tools Create account Log in. If goal BP cannot be reached with 2 drugs, add and titrate a third drug from the list provided. Retrieved from ” http: The amlodipine-based regimen prevented more major cardiovascular events aascot induced less diabetes than the atenolol-based regimen. This study was started about 6 years ago and compared the blood pressure lowering effects of Atenolol with Bendroflumethiazide to those of Amlodipine with Perindopril.
The same advice has already been given in a previous article on this [ The apparent shortfall in prevention of coronary heart disease CHD noted in early hypertension trials has been attributed to disadvantages of the diuretics and beta blockers used. Secondary outcomes suggest a possible reduction in cardiovascular morbidity and mortality using amlodipine and perindopril, although this may be ascribed to differences in blood axcot between the two study arms.
Intensive blood pressure lowering regimens had been shown in multiple randomized control trials to reduce cardiovascular moribidity and mortality. Views Read View source View history.
Articles in the Lancet and BMJ that have already been covered on this asdot have also raised this discrepancy and it has [ There was no statistical difference between the two arms of the study in this endpoint. This page was last modified on 15 Septemberat Analysis was by intention to treat.
The trial was stopped prematurely due to a large difference in all-cause mortality between the two treatment groups.
This was perhaps seen as necessary because there was a difference in the blood pressures of the two arms of 2. The incidence of developing diabetes was less on the amlodipine-based regimen vs ; bbpla. Expert Opinion — Grade E.
The outcomes of the study could be entirely driven by greater reductions in blood pressure that occurred in the Amlodipine arm. And we already know about the diabetes risk posed asccot the combination of Beta-blockers and Diuretics. We did a multicentre, prospective, randomised controlled trial in 19 patients with hypertension who were aged years and had at least three other cardiovascular risk factors.
The amlodipine-based arm had a significantly lower blood pressure than the atenolol-based arm throughout the entire study that may explain the differences in outcomes. At the same time the paper was released by the Lancetthey released another paper investigating the role of blood pressure and other variables in the results. Nevertheless, the results have implications with respect to optimum combinations of antihypertensive agents.
Accept No thanks Read more. Our primary endpoint was non-fatal myocardial infarction including silent myocardial infarction and fatal CHD. Amlodipine and perindopril does not reduce cardiovascular morbidity and mortality compared to atenolol and bendroflumethiazide.