Table 2 Study characteristics
From: Effects of elevated systolic blood pressure on ischemic heart disease: a Burden of Proof study
Study name | Author and year of publication | Population | Average follow-up (years) | Age (years) | Endpoints | Outcome definition | Intervention group | Control group |
|---|---|---|---|---|---|---|---|---|
ABCD-N | Schrier et al., 2002 (ref. 62) | Normotensive type 2 diabetic subjects identified from healthcare systems | 5.3 | 40–74 | Incidence and mortality | Myocardial infarction and heart failure | Nisoldipine or enalapril | Placebo |
ACCORD, Action to Control Cardiovascular Risk in Diabetes Study | ACCORD Study Group, 2010 (ref. 32) | High-risk participants with type 2 diabetes | 4.7 | 40–79 | Incidence and mortality | Myocardial infarction and coronary heart disease | Intensive therapy | Standard therapy |
ACTION Trial | Poole-Wilson, 2004 (ref. 60) | Ambulatory patients diagnosed with angina pectoris with and without history of myocardial infarction | 6 | 35–99 | Incidence and mortality | Myocardial infarction, angina and heart failure | Nifedipine | Placebo |
Active I | Active I Investigators, 2011 (ref. 33) | Patients with atrial fibrillation and history of cardiovascular disease (CVD) or hypertension before the study | 4.1 | 75+ | Incidence and mortality | Myocardial infarction and heart failure | Irbesartan 150 and 300 mg d–1 | Placebo |
ADVANCE | Patel et al., 2007 (ref. 58) | Patients diagnosed with type 2 diabetes mellitus at the age of 30 years or older and with history of major cardiovascular disease or at least one other risk factor for cardiovascular disease | 5 | 55–76 | Incidence and mortality | Coronary heart disease | Perindopril 2 mg and indapamide 625 mg | Placebo |
CAMELOT | Nissen et al., 2004 (ref. 56) | Individuals requiring coronary angiography for evaluation of chest pain or percutaneous coronary intervention with normal blood pressure, and without treatment and without heart failure | 2 | 30–79 | Incidence and mortality | Myocardial infarction and angina | Amlodipine or enalapril | Placebo |
CARDIO-SIS | Verdecchia et al., 2009 (ref. 69) | Patients with systolic blood pressure 150 mm Hg or higher, receiving antihypertensive treatment for at least 12 weeks and without diabetes | 2 | 55+ | Incidence and mortality | Myocardial infarction and heart failure | Tight control (<130 mm Hg) of SBP | Usual control (<140 mm Hg) of SBP |
DIABHYCAR | Marre et al., 2004 (ref. 52) | Individuals with type 2 diabetes and urinary albumin excretion ≥20 mg l–1 | 4 | 52–78 | Incidence and mortality | Myocardial infarction and heart failure | Ramipril | Placebo |
DREAM, Diabetes REduction Assessment with ramipril and rosiglitazone Medication | DREAM Trial Investigators, 2006 (ref. 40) | People with impaired fasting plasma glucose or impaired glucose tolerance and without diabetes or cardiovascular disease | 3 | 30+ | Incidence and mortality | Myocardial infarction, heart failure and angina | Ramipril | Placebo |
Dutch TIA | The Dutch TIA Trial Study Group, 1993 (ref. 67) | Patients who were seen by a neurologist in one of the 56 collaborating centers and who had a transient ischemic attack or nondisabling ischemic stroke | 2.7 | 18+ | Incidence and mortality | Coronary heart disease | Atenolol | Placebo |
EUROPA, EUropean trial on Reduction of cardiac events with Perindopril in patients with stable coronary artery disease study | Fox et al., 2003 (ref. 41) | Patients with evidence of coronary heart disease and without heart failure | 4.2 | 45–75 | Incidence | Myocardial infarction | Perindopril | Placebo |
EWPHE, European Working Party on High blood pressure in the Elderly | Amery et al., 1985 (ref. 34) | Patients with systolic blood pressure within the limits 160–239 mm Hg and without CVD | 4.6 | 60+ | Mortality | Coronary heart disease | Hydrochlorothiazide + triamterene | Placebo |
FEVER Felodipine Event Reduction Study | Liu et al., 2005 (ref. 48) | Individuals with systolic blood pressure 210 mm Hg or less and DBP <115 mm Hg if under antihypertensive treatment; or systolic blood pressure 160–210 mm Hg or DBP 95–115 mm Hg if untreated | 3.3 | 50–79 | Incidence and mortality | Coronary heart disease | Felodipine | Placebo |
HOPE-3, Heart Outcomes Prevention Evaluation study 3 | Lonn et al., 2016 (ref. 49) | Individuals without cardiovascular disease and with at least one of the following cardiovascular risk factors: elevated waist-to-hip ratio, history of low concentration of high-density lipoprotein cholesterol, current or recent tobacco use, dysglycemia, family history of premature coronary disease and mild renal dysfunction | 5.6 | 55+ | Incidence and mortality | Myocardial infarction, heart failure and angina and revascularization | Candesartan + hydrochlorothiazide | Placebo |
HOPE, Heart Outcomes Prevention Evaluation study | Heart Outcomes Prevention Evaluation Study Investigators, 2000 (ref. 44) | Individuals with history of cardiovascular disease and/or diabetes plus at least one other cardiovascular risk factor (hypertension, elevated cholesterol levels, cigarette smoking or microalbuminuria) | 5.6 | 55+ | Incidence and mortality | Myocardial infarction | Ramipril 2.5 mg | Placebo |
HOT, Hypertension Optimal Treatment | Hannson et al., 1998 (ref. 43) | Patients with hypertension and DBP 100–115 mm Hg | 3.8 | 50–80 | Incidence and mortality | Myocardial infarction | Diastolic control target <80 mm Hg | Placebo, diastolic control target <90 mm Hg |
HYVET | Beckett et al., 2008 (ref. 36) | Population with systolic blood pressure 160 mm Hg or more. | 1.8 | 80+ | Incidence and mortality | Myocardial infarction and heart failure | Indapamide 1.5 mg | Placebo |
MRC 2 Medical Research Council trial of treatment of hypertension | MRC Working Party, 1992 (ref. 53) | Hypertensive older patients without history of myocardial infarction or stroke, diabetes or impaired renal function within the preceding 3 months, had impaired renal function, asthma or any serious intercurrent disease | 5.8 | 65–74 | Incidence and mortality | Coronary heart disease | Diuretic or beta-blocker (atenolol 50 mg d–1 hydrochlorothiazide 25 or 50 mg d–1 + amiloride 2.5 or 5.0 mg d–1) | Placebo |
MRFIT, Multiple Risk Factor Intervention Triala | Stamler et al., 1989a (ref. 30) | Men with no history of hospitalization for heart attack | 6 | 35–57 | Mortality | Coronary heart disease | NAa | NAa |
NAVIGATOR | NAVIGATOR Study Group, 2010 (ref. 54) | Patients with impaired glucose tolerance, and one or more CVD risk factors or known CV disease | 6.5 | 53–74 | Incidence and mortality | Myocardial infarction, unstable angina and heart failure | Valsartan | Placebo |
PART 2 The Prevention of Atherosclerosis with Ramipril trial | MacMahon et al., 200 (ref. 51) | Patients with hospital diagnosis (within 5 years of enrollment) or cardiovascular disease | 4.7 | 49–75 | Incidence and mortality | Coronary heart disease, myocardial infarction and unstable angina | Ramipril | Placebo |
PATS Post-stroke Antihypertensive Treatment Study | Liu et al., 2009 (ref. 47) | Individuals with a history of stroke or transient ischemic attack | 2 | 47–73 | Incidence and mortality | Myocardial infarction | Indapamide 2.5 mg d–1 | Placebo |
PEACE, Prevention of Events with Angiotensin Converting Enzyme Inhibition Trial | Braunwald et al., 2004 (ref. 37) | Patients with stable coronary artery disease and normal or slightly reduced left ventricular function | 4.8 | 52–76 | Incidence | Myocardial infarction | Trandolapril 4 mg d–1 | Placebo |
PHARAO | Lüders et al., 2008 (ref. 50) | Internists and general practitioners with high-normal blood pressure | 3 | 50–85 | Incidence and mortality | Myocardial infarction | Ramipril 1.5 mg | Placebo |
PREVEND IT | Asselbergs et al., 2004 (ref. 35) | Patients with angiographic evidence of coronary artery disease | 3 | 30–80 | Incidence and mortality | Myocardial infarction and angina | Fosinopril 20 mg | Placebo |
PREVENT | Pitt et al., 2000 (ref. 59) | Patients with angiographic evidence of coronary artery disease | 3 | 30–80 | Incidence and mortality | Myocardial infarction and angina | Amlodipine | Placebo |
PRoFESS Prevention Regimen For Effectively Avoiding Second Strokes Study | Yusuf et al., 2008 (ref. 70) | Patients who had had an ischemic stroke <90 days before randomization and whose condition was stable | 3 | 55+ | Incidence and mortality | Myocardial infarction | Telmisartan | Placebo |
PROGRESS The perindopril protection against recurrent stroke study | PROGRESS Collaborative Group, 2001 (ref. 61) | Individuals with a history of stroke or transient ischemic attack | 3.9 | 49–79 | Incidence and mortality | Coronary heart disease | Perindopril 4 mg | Placebo |
PSC, Prospective Studies Collaborationa | Lewington et al., 2002a (ref. 31) | Adults with no previous vascular disease recorded at baseline | 40–89 | Mortality | IHD | NA | NA | |
RENAAL | Brenner et al., 2001 (ref. 38) | Patients with type 2 diabetes and nephropathy | 3.4 | 31–70 | Incidence and mortality | Myocardial infarction and heart failure | Losartan | Placebo |
SCOPE, Study on COgnition and Prognosis in the Elderly | Lithell et al., 2003 (ref. 45) | Patients with mild to moderate hypertension | 3.7 | 70–80 | Incidence and mortality | Myocardial infarction | Candesartan 16 mg d–1 | Placebo |
SHEP Systolic Hypertension in the Elderly Program | SHEP Cooperative Research Group, 1984 (ref. 63) | Older population with isolated systolic hypertension | 4.5 | 60+ | Incidence and mortality | Coronary heart disease | For step 1 of the trial, dose 1 was chlorthalidone 12.5 mg d–1 or matching placebo; dose 2 was 25 mg d–1; for step 2, dose 1 was atenolol 25 mg d–1 or matching placebo; dose 2 was 50 mg/ d–1 | Placebo |
SPRINT | SPRINT Research Group, 2015 (ref. 64) | Individuals with systolic blood pressure 130–180 mm Hg and increased risk of CVD events | 3.3 | 50+ | Incidence and mortality | Myocardial infarction | Intensive treatment | Standard treatment |
SPS3 Secondary Prevention of Small Subcortical Strokes trial | SPS3 Study Group, 2013 (ref. 65) | Individuals who had had a recent (within 180 days), symptomatic, agnetic resonance imaging-confirmed lacunar stroke and were without surgically amenable ipsilateral carotid artery stenosis or high-risk cardioembolic sources | 3.7 | 30+ | Incidence and mortality | Myocardial infarction | Lower target <130 mm Hg | Higher target (130–149 mm Hg) |
STOP-Hypertension | Dahlöf et al., 1991 (ref. 39) | Untreated patients with systolic blood pressure 180 mm Hg or above or DBP >105 mm Hg, irrespective | 2 | 70–82 | Incidence and mortality | Myocardial infarction | Atenolol 50 mg, hydrochlorothiazide 25 mg + amiloride 2–5 mg, metoprolol 100 mg or pindolol 5 mg | Placebo |
Syst-China | Liu et al., 1998 (ref. 46) | Older patients with isolated systolic hypertension and without cardiovascular disease | 3 | 60+ | Incidence and mortality | Coronary heart disease | Itrendipine, with the possible addition of captopril, hydrochlorothiazide or both | Placebo |
The BBB Study | Hannson et al., 1994 (ref. 42) | Treated hypertensive patients with DBP 90–100 mm Hg and without history or clinical signs of coronary heart disease | 5 | 45–67 | Incidence and mortality | Myocardial infarction | Intensified treatment | Unchanged treatment to maintain DBP in the range 90–100 mm Hg |
TOMHS | Neaton et al., 1993 (ref. 55) | Individuals not taking antihypertensive medication and with DBP 90–99 mm Hg. | 4.4 | 45–69 | Incidence and mortality | Coronary heart disease | Nutritional-hygienic intervention + one of the following: placebo; chlorthalidone 15 mg d–1; acebutolol 400 mg d–1; doxazosin mesylate 1 mg d–1 for 1 month, then 2 mg d–1; amlodipine maleate 5 mg d–1; or enalapril maleate 5 mg d–1 | Placebo |
TRANSCEND, Telmisartan Randomized Assessment Study | TRANSCEND Investigators, 2008 (ref. 66) | Angiotensin-converting enzyme (ACE)-intolerant subjects with cardiovascular disease | 4.7 | 55+ | Incidence and mortality | Myocardial infarction | Telmisartan 80 mg d–1 | Placebo |
UKPDS UK Prospective Diabetes Study (UKPDS 38) | UK Prospective Diabetes Study Group, 1999 (ref. 68) | Hypertensive patients with type 2 diabetes and without history of myocardial infarction in the previous year, current angina or heart failure | 8.4 | 25+ | Incidence and mortality | Myocardial infarction | ACE inhibitor to maximal doses or beta-blocker to maximal doses | Avoid ACE inhibitors and beta-blockers |
VALISH Valsartan in Elderly Isolated Systolic Hypertension Study | Ogihara et al., 2010 (ref. 57) | Patients with isolated systolic hypertension | 3.07 | 70–84 | Incidence and mortality | Myocardial infarction | Valsartan | Valsartan |
