ras阻斷劑治療高血壓優勢及存在的問題 傅國勝.ppt

ARB預防動脈粥樣硬化
對照組
***沙坦
冠狀動脈內膜
* p < 0.01
LAD
LCX
0.000
0.025
0.050
0.075
*
*
mm2
Strawn et al. Circulation, 2ks of treatment (titration up to losartan/HCTZ 100mg/12.5mg) in those who were sub optimally treated with Mono therapies (ARB or ACE)
*BP Goal:
Trough sitting DBP
<90 mmHg (non-diabetics)
<80 mmHg (diabetics)
Data on File, MSD
36
MERIT-HF, AHA nov 98
HEAALTH
Secondary objectives:
Measure mean changes from baseline to endpoint in SiDBP and SiSBP
Responder rate (i.e. % of pts who reach BP goal or at least 10 mmHg decrease in SiDBP)
3. Percentage of patients who reach BP goal after 4 and 12 weeks
4. Estimate safety profile and tolerability
Data on File, MSD
37
MERIT-HF, AHA nov 98
HEAALTH
Tertiary objectives:
Estimate losartan/HCTZ efficacy in patient subgroups
Diabetics
ECG-LVH
Obesity
BP goal
Responder rate
Measure mean change in microalbuminuria
Measure mean change in Framingham stroke risk score
Data on File, MSD
38
MERIT-HF, AHA nov 98
HEAALTH
Week -1
Week 0
Week 4
Week 8
Week 12
Losartan
50 mg /HCTZ 12.5 mg
Losartan
100 mg /HCTZ 12.5 mg
Losartan
100 mg /HCTZ 25 mg
Data on File, MSD
39
MERIT-HF, AHA nov 98
HEAALTH – Results (primary variable)
Adapted from Data on File, MSD
Full set analysis population
40
MERIT-HF, AHA nov 98
HEAALTH – BP lowering efficacy in patients uncontrolled on ARB or ACE-I
Adapted from Data on File, MSD
Full set analysis population
41
MERIT-HF, AHA nov 98
HEAALTH – BP lowering efficacy in patients uncontrolled on ARB or ACE-I
Refs: 1. Data on File, MSD; 2. Kim KS, et al. Paper presented at: 6th Annual Asian-Pacific Congress of Hypertension; November 2019; Beijing, China ; APCH2019-01-015.
Full set analysis population
42
MERIT-HF, AHA nov 98
HEAALTH – Framingham Stroke Risk
Adapted from Data on File, MSD
Full set analysis population
43
MERIT-HF, AHA nov 98
HEAALTH – Subpopulation analysis
Patients who reached BP goal* after 8 weeks of treatment