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Titolo:
FINAL OUTCOME RESULTS OF THE MULTICENTER ISRADIPINE DIURETIC ATHEROSCLEROSIS STUDY (MIDAS) - A RANDOMIZED CONTROLLED TRIAL
Autore:
BORHANI NO; MERCURI M; BORHANI PA; BUCKALEW VM; CANOSSATERRIS M; CARR AA; KAPPAGODA T; ROCCO MV; SCHNAPER HW; SOWERS JR; BOND MG;
Indirizzi:
BOWMAN GRAY SCH MED,NEPHROL SECT,DEPT INTERNAL MED,MED CTR BLVD WINSTON SALEM NC 27157 BOWMAN GRAY SCH MED,NEPHROL SECT,DEPT INTERNAL MED WINSTON SALEM NC 27157 UNIV CALIF DAVIS,SCH MED,DIV CARDIOVASC MED DAVIS CA 95616 UNIV CALIF DAVIS,SCH MED,DEPT INTERNAL MED DAVIS CA 95616 UNIV NEVADA,SCH MED,DEPT FAMILY & COMMUNITY MED RENO NV 89557 BOWMAN GRAY SCH MED,DIV VASC ULTRASOUND RES WINSTON SALEM NC 27157 HEART RES INST,CLIN TRIALS UNIT MIAMI FL 00000 CIRCULATORY DIS CTR AUGUSTA GA 00000 SCI APPLICAT CO INC BIRMINGHAM AL 00000 PREVENT CARDIOL INC BIRMINGHAM AL 00000 WAYNE STATE UNIV,DIV ENDOCRINOL METAB & HYPERTENS DETROIT MI 00000
Titolo Testata:
JAMA, the journal of the American Medical Association
fascicolo: 10, volume: 276, anno: 1996,
pagine: 785 - 791
SICI:
0098-7484(1996)276:10<785:FOROTM>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY HEART-DISEASE; B-MODE ULTRASOUND; CAROTID ATHEROSCLEROSIS; CALCIUM-ANTAGONISTS; DESIGN-FEATURES; RISK-FACTORS; HYPERTENSION; MORTALITY; REPRODUCIBILITY; MORBIDITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
39
Recensione:
Indirizzi per estratti:
Citazione:
N.O. Borhani et al., "FINAL OUTCOME RESULTS OF THE MULTICENTER ISRADIPINE DIURETIC ATHEROSCLEROSIS STUDY (MIDAS) - A RANDOMIZED CONTROLLED TRIAL", JAMA, the journal of the American Medical Association, 276(10), 1996, pp. 785-791

Abstract

Objective.-To compare the rate of progression of mean maximum intimal-medial thickness (IMT) in carotid arteries, using quantitative B-modeultrasound imaging, during antihypertensive therapy with isradipine vs hydrochlorothiazide. Design.-Randomized, double-blind, positive-controlled trial. Setting.-Nine medical center clinics. Population.-A total of 883 patients with baseline mean+/-SD systolic and diastolic bloodpressure (SBP and DBP, respectively) of 149.7+/-16.6 and 96.5+/-5.1 mm Hg, age of 58.5+/-8.5 years, and maximum IMT of 1.17+/-0.20 mm. Interventions.-Twice daily doses of isradipine (2.5-5.0 mg) or hydrochlorothiazide (12.5-25 mg). Main Outcome Measure (Primary End Point).-Rate of progression of mean maximum IMT in 12 carotid focal points over 3 years. Results.-There was no difference in the rate of progression of mean maximum IMT between isradipine and hydrochlorothiazide over 3 years (P=.68). There was a higher incidence of major vascular events (eg, myocardial infarction, stroke, congestive heart failure, angina, and sudden death) in isradipine (n=25; 5.65%) vs hydrochlorothiazide (n=14;3.17%) (P=.07), and a significant increase in nonmajor vascular events and procedures (eg, transient ischemic attack, dysrhythmia, aortic valve replacement, and femoral popliteal bypass graft) in isradipine (n=40; 9.05%) vs hydrochlorothiazide (n=23; 5.22%) (P=.02). At 6 months,mean DBP decreased by 13.0 mm Hg in both groups, and mean SEP decreased by 19.5 mm Hg in hydrochlorothiazide and 16.0 mm Hg in isradipine (P=.002); the difference in SBP between the 2 groups persisted throughout the study but did not explain the increased incidence of vascular events in patients treated with isradipine. Conclusion.-The rate of progression of mean maximum IMT in carotid arteries, the surrogate end point in this study, did not differ between the 2 treatment groups. The increased incidence of vascular events in patients receiving isradipine compared with hydrochlorothiazide is of concern and should be studied further.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 10:28:49