ANTIHYPERTENSIVE LIPID-LOWERING HEART ATTACK PREVENTION THERAPY

抗高血压降脂预防心脏病治疗

• 批准号: 6310021
• 负责人: TAMRAT M RETTA
• 金额: $ 20.62万
• 依托单位: HOWARD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-12-01 至 2001-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6310021
• 关键词: African American; HMG coA reductases; antihypercholesterolemic agent; antihypertensive agents; cardiovascular disorder chemotherapy; cardiovascular disorder prevention; clinical research; disease /disorder proneness /risk; diuretics; health care cost /financing; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; myocardial infarction; oxidoreductase inhibitor; quality of life

An estimated 50 million people in the U.S. have high blood pressure (systolic blood pressure [SBP] >140mmHg and/or diastolic BP [DBP] >90mmHg), or are taking antihypertensive medications. All factors considered and remaining constant, the incremental cost of treating 25 million patients with a drug costing $100/patient-year of therapy compared to one costing $500/patient-year of therapy is $10 billion. Hypertension is considered more frequent among African Americans than Caucasians, and its sequelae are also seen more frequently in African Americans. Thus, the ALLHAT trial, a nationwide, practice-based, randomized clinical trial of antihypertensive pharmacological treatments and cholesterol-lowering to prevent heart attacks in a specific subset of 40,000 high-risk hypertensive patients, is to include at least 55% African Americans. The purpose of the antihypertensive treatment arm is to determine the combined incidence of fatal coronary heart disease and non-fatal myocardial infarction between diuretic treatment and three alternative (and more expensive) antihypertensive pharmacological treatments. The purpose of the lipid-lowering treatment arm is to determine if lowering serum cholesterol in moderately hypercholesterolemic men and women aged 60 years and older, with a specific 3-hydroxymethylglutaryl coenzyme A reductase inhibitor, will reduce all-cause mortality as compared to a control group receiving "usual care." Secondary objectives of both trial components are to compare the effects of their respective treatment regimens on cardiovascular mortality, major morbidity, health costs, and health-related quality of life.

估计在美国有5000万人患有高血压（收缩压[SBP]> 140mmHg和/或舒张压BP [DBP]> 90mmHg），或正在服用降压药。 考虑并保持恒定的所有因素，治疗2500万名药物的治疗费用为100美元/患者年治疗的增量成本，而每/患者年治疗的费用为500美元，为100亿美元。在非洲裔美国人中，高血压比高加索人更频繁，而在非洲裔美国人中也更频繁地看到其后遗症。 因此，Allhat试验是一项全国性的，基于实践的，基于实践的，随机的临床试验，对降压药物治疗和降低胆固醇，以防止40,000个高危高血压患者的特定子集中的心脏病发作，其中包括至少55％的非洲裔美国人。 降压治疗组的目的是确定利尿剂治疗与三种替代性（且更昂贵的）抗二手药物治疗之间致命性冠心病和非致命性心肌梗死的综合发生率。 降脂治疗臂的目的是确定与对照组相比，与对照组相比，将减少所有原因的死亡率。 这两个试验组成部分的次要目标都是比较其各自治疗方案对心血管死亡率，主要发病率，健康成本和与健康相关的生活质量的影响。