ASCOT-BPLAAnglo-Scandinavian Cardiac Outcomes Trial - Blood Pressure Lowering Arm
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Poulter et al., "Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial," The Lancet, vol.
ASCOT-BPLA compares amlodipine based regimens with atenolol based regimens in patients with hypertension and other vascular risk factors.
ASCOT-BPLA 19257 patients were included in the study over a period of approximately 5 years and the study was halted early because of all cause mortality reduction benefit the risk of stroke.
New-Onset Diabetes New Analysis of the Blood Pressure Lowering Arm of ASCOT (ASCOT-BPLA) European Society of Cardiology 2006 World Congress.
In the ASCOT-BPLA trial amlodipine based treatment resulted in a 1.7 mm Hg mean lower systolic blood pressure and 2.0 mm Hg mean lower diastolic blood pressure, resulting in a 14% lower risk of coronary events and 23% decrease in stroke rate compared to [beta]-blocker (atenolol) based treatment (7).
In the ASCOT-BPLA study, there was a 30% increased incidence of new onset diabetes in the [beta]-blocker (atenolol) arm when compared to the amlodipine arm (7).
A careful reading of ASCOT-BPLA, then, makes it clear that this study does not support the notion that newer antihypertensives (calcium channel blockers and ACE inhibitors) are superior to older ones (beta-blockers and diuretics).