非糖尿病高血圧患者の血圧コントロールも、より厳しく130mmHg未満を目標に：Cardio-Sis

非糖尿病高血圧患者の理想的な降圧目標レベルはまだわかっていない。イタリアHospitalS Maria della MisericordiaのPaolo Verdecchia氏らの研究グループは、目標とすべき収縮期血圧値が、一般的な目標値と比較してより厳しいほうが、それら患者にとって有益であるとの仮説を検証する非盲検無作為化試験Cardio-Sisを行った。Lancet誌2009年8月15日号よりケアネット速報より

Verdecchia P et al. – Findings support a lower blood pressure goal than currently recommended fornon-diabetic hypertensive pts.Methods• Study of whether tight vs usual control of systolic blood pressure may benefit non-diabetichypertensive pts• Randomized open-label trial in 44 centers in Italy• Subjects: 1111 non-diabetic pts with systolic blood pressure ≥150 mm Hg• Randomization to target systolic blood pressure: <140 mm Hg (usual control; 553 pts) or<130 mm Hg (tight control; 558 pts)• Primary endpoint: rate of electrocardiographic left ventricular hypertrophy 2 yrs afterrandomization• Intention-to-treat analysisResults• Median follow-up: 2 yrs• Mean systolic/diastolic blood pressure reduction: usual-control group by 23.5/8.9 and tightcontrolgroup by 27.3/10.4 mm Hg• Primary endpoint: 82 of 483 pts (17%) in usual-control group and 55 of 484 pts (11.4%) intight-control group• Composite cardiovascular endpoint: 52 (9.4%) pts in usual-control group and 27 (4.8%) intight-control group• Side-effects: rare; did not differ significantly between groups