TY - JOUR
T1 - Influence of diabetes and type of hypertension on response to antihypertensive treatment
AU - Brown, Morris J.
AU - Castaigne, Alain
AU - De Leeuw, Peter W.
AU - Mancia, Giuseppe
AU - Palmer, Christopher R.
AU - Rosenthal, Talma
AU - Ruilope, Luis M.
PY - 2000/5
Y1 - 2000/5
N2 - The aim of our investigation was to determine whether the presence of additional risk factors or type of hypertension (diastolic or isolated systolic) influences blood pressure (BP) response to treatment. The International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study is a double-blinded outcome comparison of calcium channel blockade with diuretics in high-risk patients aged 55 to 80 years. Dynamic randomization between nifedipine once daily and hydrochlorothiazide/amiloride was performed to ensure that approximately equal numbers of patients in the 2 groups had each of the major cardiovascular risk factors. Patients with isolated systolic hypertension were also separately randomized. Atenolol or enalapril was the mandatory second-line drug. In 5669 patients who completed the 18-week titration, BP fell from 172±15/99±9 mm Hg (mean±SD) while receiving placebo to 139±12/82±7 mm Hg. Twenty-six percent of patients required 2 drugs, and 4% required 3 drugs. Patients with diabetes were the most resistant to treatment, requiring second and third drugs 40% and 100% more frequently than patients without diabetes and achieving marginally the highest final BP, for any risk group, of 141±13/82±8 mm Hg. Age, smoking, gender, hypercholesterolemia, left ventricular hypertrophy, and existing atherosclerosis had little (
AB - The aim of our investigation was to determine whether the presence of additional risk factors or type of hypertension (diastolic or isolated systolic) influences blood pressure (BP) response to treatment. The International Nifedipine GITS Study: Intervention as a Goal in Hypertension Treatment (INSIGHT) study is a double-blinded outcome comparison of calcium channel blockade with diuretics in high-risk patients aged 55 to 80 years. Dynamic randomization between nifedipine once daily and hydrochlorothiazide/amiloride was performed to ensure that approximately equal numbers of patients in the 2 groups had each of the major cardiovascular risk factors. Patients with isolated systolic hypertension were also separately randomized. Atenolol or enalapril was the mandatory second-line drug. In 5669 patients who completed the 18-week titration, BP fell from 172±15/99±9 mm Hg (mean±SD) while receiving placebo to 139±12/82±7 mm Hg. Twenty-six percent of patients required 2 drugs, and 4% required 3 drugs. Patients with diabetes were the most resistant to treatment, requiring second and third drugs 40% and 100% more frequently than patients without diabetes and achieving marginally the highest final BP, for any risk group, of 141±13/82±8 mm Hg. Age, smoking, gender, hypercholesterolemia, left ventricular hypertrophy, and existing atherosclerosis had little (
KW - Antihypertensive therapy
KW - Calcium channel blockers
KW - Cardiovascular diseases
KW - Diabetes mellitus
KW - Diuretics
KW - Random allocation
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M3 - Article
C2 - 10818061
AN - SCOPUS:0034116259
VL - 35
SP - 1038
EP - 1042
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 5
ER -