Achievements and problems of modern trials of antihypertensive drugs

Most important value of lowering of substantially elevated arterial pressure (AP) for improvement of outcomes in patients with arterial hypertension (AH) was convincingly confirmed by large truly placebo controlled randomized clinical trials (RCT) with the use of mainly diuretics, and/or (i-adrenoblockers in the 6O-80ths. Later comparative RCT confirmed equal antihypertensive efficacy of 5 main drug classes relative to AP level in brachial artery. In this review we discuss merit of auxiliary class-specific properties of antihypertensive agents potentially affecting prognosis besides AP lowering. We also discuss problems related to decline of significance of quantitative criteria of AH and consideration of AP level in general context of cardiovascular risk; problems of external validity of RCT; extrapolation of RCT results obtained in patients with complicated AH and very high cardiovascular risk on young patients with uncomplicated AH; significance of hard and surrogate end points.

Journal
Publisher
KlinMed Consulting
Number of issue
1
Language
Russian
Pages
91-99
Status
Published
Volume
51
Year
2011
Organizations
  • 1 Russian University of Peoples Friendship, ul. Vavilova 61, 117292 Moscow, Russian Federation
Keywords
Antihypertensive drugs; Arterial hypertension; Cardiovascular risk; Randomized clinical trials
Date of creation
19.10.2018
Date of change
19.10.2018
Short link
https://repository.rudn.ru/en/records/article/record/2425/
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