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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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. Expert Opinion — Grade E. Amlodipine and perindopril does asfot reduce cardiovascular morbidity and mortality compared to atenolol and bendroflumethiazide.
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.
Though not significant, compared with the atenolol-based regimen, fewer individuals on the amlodipine-based regimen had a primary endpoint vs ; unadjusted HR 0. This process is bp,a to take six months.
blla This was perhaps seen as necessary because there was a difference in the blood pressures of the two arms of 2.
The trial was stopped prematurely due to a large difference in all-cause mortality between the two treatment groups. The incidence of developing diabetes was less on the amlodipine-based regimen vs ; 0. This blog is maintained by Matthew Robinson. 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.
Views Read View source View history. For a given reduction in blood pressure, some suggested that newer agents would confer advantages over diuretics and beta blockers.
For example there was less peripheral arterial disease and development of diabetes in the Amlodipine vpla Perindopril arm. Navigation menu Personal tools Create account Log in. Nevertheless, the results have implications with respect to optimum combinations of antihypertensive agents.
The study was stopped prematurely after 5. Accept No thanks Read more.
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. At the time, ascoy channel blockers CCBs and ACE inhibitors ACEIs were novel antihypertensive agents hypothesized to have less adverse metabolic effects and provide additional cardiovascular protection beyond its blood pressure effects.
For more detail, read on. The same advice has already been given in a previous article on this [ And we already know about the diabetes risk posed by the combination of Beta-blockers and Diuretics. However, the size of benefit pbla significantly less than predicted compared to previous observational studies . This page was last modified on 15 Septemberat Secondary outcomes suggest acot possible reduction in cardiovascular morbidity and mortality using amlodipine and perindopril, although this may be ascribed to differences in blood pressure between the two study arms.
ASCOT-BPLA – Wiki Journal Club
If these limitations in the study are accepted does it add anything new to the body of evidence in Hypertension? Retrieved from ” http: Articles in the Lancet and BMJ that have already been covered on this website have also raised this discrepancy and it has [ There was no statistical difference between the two arms of the study in this endpoint.
On the basis of previous trial evidence, these effects might not be entirely explained by better control of blood pressure, and this issue is addressed in the accompanying article. Our primary endpoint was non-fatal myocardial infarction including silent myocardial infarction and fatal CHD.