Ascot trial pdf

With the exception of female gender, all of the prespecified subgroups favored the atorvastatin arm for the primary endpoint, with no heterogeneity in any subgroup. Subanalysis of side-effects: During the blinded phase, the incidence of important adverse events, including muscle-related 2. In contrast, during the unblinded phase, nonrandomized phase, muscle-related adverse events were higher in the atorvastatin arm 1.

All-cause mortality: 3. Among patients with hypertension and relatively low cholesterol, treatment with atorvastatin was associated with a reduction in the primary endpoint of nonfatal MI and fatal CHD at 3-year follow-up.

Results were sustained in the subset of patients with approximately 16 years of follow-up. The incidence of developing diabetes was less on the amlodipine-based regimen vs ; 0. Secondary outcomes suggest a 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.

Expert Opinion — Grade E. The amlodipine-based arm had a significantly lower blood pressure than the atenolol-based arm throughout the entire study that may triwl the differences in outcomes. Amlodipine and perindopril does not reduce cardiovascular morbidity and mortality compared to atenolol and bendroflumethiazide. The apparent shortfall in prevention of coronary heart disease CHD noted in acsot-bpla hypertension trials has been asdot-bpla to disadvantages of the diuretics and beta blockers used.

Our aim, tral, was to compare the effect on non-fatal myocardial infarction and fatal CHD of combinations of atenolol with a thiazide versus amlodipine with perindopril. The lack of statistical significance may have been due to early trial termination, as the trial did ascot-pbla meet the pre-specified number of primary events of 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.

It was hypothesized that adverse side effects of older antihypertensive agents, such as beta-blockers and diuretics, was partially offsetting the benefit of blood pressure reduction [1]. Our primary endpoint was non-fatal myocardial infarction including silent myocardial infarction and fatal CHD. Our primary endpoint was non-fatal myocardial infarction including silent myocardial infarction and fatal CHD. For a given reduction in blood pressure, some suggested that newer agents would confer advantages over diuretics and beta blockers.

Among triall patients at high risk of cardiovascular disease, does a combination regimen of amlodipine and perindopril prevent more cardiovascular events than atenolol and bendroflumethiazide?

Secondary outcomes suggest a possible reduction in cardiovascular morbidity and mortality using amlodipine and perindopril, although this may be tril to differences in blood pressure between the two study arms. At the time, calcium channel blockers CCBs and ACE inhibitors ACEIs were novel antihypertensive agents hypothesized to have less adverse metabolic effects and provide additional cardiovascular aecot-bpla beyond its blood pressure effects.

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