Clinical impacts of additive use of olmesartan in hypertensive patients with chronic heart failure: the supplemental benefit of an angiotensin receptor blocker in hypertensive patients with stable heart failure using olmesartan (SUPPORT) trial
We examined whether an additive treatment with an angiotensin receptor blocker, olmesartan, reduces the mortality and morbidity in hypertensive patients with chronic heart failure (CHF) treated with angiotensin-converting enzyme (ACE) inhibitors, β-blockers, or both. In this prospective, randomized, open-label, blinded endpoint study, a total of 1147 hypertensive patients with symptomatic CHF (mean age 66 years, 75% male) were randomized to the addition of olmesartan (n = 578) to baseline therapy vs. control (n = 569). The primary endpoint was a composite of all-cause death, non-fatal acute myocardial infarction, non-fatal stroke, and hospitalization for worsening heart failure. During a median follow-up of 4.4 years, the primary endpoint occurred in 192 patients (33.2%) in the olmesartan group and in 166 patients (29.2%) in the control group [hazard ratio (HR) 1.18; 95% confidence interval (CI), 0.96-1.46, P = 0.112], while renal dysfunction developed more frequently in the olmesartan group (16.8 vs. 10.7%, HR 1.64; 95% CI 1.19-2.26, P = 0.003). Subgroup analysis revealed that addition of olmesartan to combination of ACE inhibitors and β-blockers was associated with increased incidence of the primary endpoint (38.1 vs. 28.2%, HR 1.47; 95% CI 1.11-1.95, P = 0.006), all-cause death (19.4 vs. 13.5%, HR 1.50; 95% CI 1.01-2.23, P = 0.046), and renal dysfunction (21.1 vs. 12.5%, HR 1.85; 95% CI 1.24-2.76, P = 0.003). Additive use of olmesartan did not improve clinical outcomes but worsened renal function in hypertensive CHF patients treated with evidence-based medications. Particularly, the triple combination therapy with olmesartan, ACE inhibitors and β-blockers was associated with increased adverse cardiac events. This study is registered at clinicaltrials.gov-NCT00417222..
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2015 |
|---|---|
| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
|---|---|
| Enthalten in: |
European heart journal - 36(2015), 15, Seite 915 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Sakata, Yasuhiko [VerfasserIn] |
|---|
| Links: |
|---|
| doi: |
10.1093/eurheartj/ehu504 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
OLC1956953469 |
|---|
| LEADER | 01000caa a2200265 4500 | ||
|---|---|---|---|
| 001 | OLC1956953469 | ||
| 003 | DE-627 | ||
| 005 | 20230714142205.0 | ||
| 007 | tu | ||
| 008 | 160206s2015 xx ||||| 00| ||eng c | ||
| 024 | 7 | |a 10.1093/eurheartj/ehu504 |2 doi | |
| 028 | 5 | 2 | |a PQ20160617 |
| 035 | |a (DE-627)OLC1956953469 | ||
| 035 | |a (DE-599)GBVOLC1956953469 | ||
| 035 | |a (PRQ)c1242-c6f7e2df8b55e12efeb9f70ec1ef42202bc03a70832899ece4ce6a03b152487f0 | ||
| 035 | |a (KEY)0136284420150000036001500915clinicalimpactsofadditiveuseofolmesartaninhyperten | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q DNB |
| 100 | 1 | |a Sakata, Yasuhiko |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Clinical impacts of additive use of olmesartan in hypertensive patients with chronic heart failure: the supplemental benefit of an angiotensin receptor blocker in hypertensive patients with stable heart failure using olmesartan (SUPPORT) trial |
| 264 | 1 | |c 2015 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 520 | |a We examined whether an additive treatment with an angiotensin receptor blocker, olmesartan, reduces the mortality and morbidity in hypertensive patients with chronic heart failure (CHF) treated with angiotensin-converting enzyme (ACE) inhibitors, β-blockers, or both. In this prospective, randomized, open-label, blinded endpoint study, a total of 1147 hypertensive patients with symptomatic CHF (mean age 66 years, 75% male) were randomized to the addition of olmesartan (n = 578) to baseline therapy vs. control (n = 569). The primary endpoint was a composite of all-cause death, non-fatal acute myocardial infarction, non-fatal stroke, and hospitalization for worsening heart failure. During a median follow-up of 4.4 years, the primary endpoint occurred in 192 patients (33.2%) in the olmesartan group and in 166 patients (29.2%) in the control group [hazard ratio (HR) 1.18; 95% confidence interval (CI), 0.96-1.46, P = 0.112], while renal dysfunction developed more frequently in the olmesartan group (16.8 vs. 10.7%, HR 1.64; 95% CI 1.19-2.26, P = 0.003). Subgroup analysis revealed that addition of olmesartan to combination of ACE inhibitors and β-blockers was associated with increased incidence of the primary endpoint (38.1 vs. 28.2%, HR 1.47; 95% CI 1.11-1.95, P = 0.006), all-cause death (19.4 vs. 13.5%, HR 1.50; 95% CI 1.01-2.23, P = 0.046), and renal dysfunction (21.1 vs. 12.5%, HR 1.85; 95% CI 1.24-2.76, P = 0.003). Additive use of olmesartan did not improve clinical outcomes but worsened renal function in hypertensive CHF patients treated with evidence-based medications. Particularly, the triple combination therapy with olmesartan, ACE inhibitors and β-blockers was associated with increased adverse cardiac events. This study is registered at clinicaltrials.gov-NCT00417222. | ||
| 540 | |a Nutzungsrecht: © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology. | ||
| 650 | 4 | |a Hypertension - drug therapy | |
| 650 | 4 | |a Tetrazoles - therapeutic use | |
| 650 | 4 | |a Heart Failure - physiopathology | |
| 650 | 4 | |a Angiotensin II Type 1 Receptor Blockers - therapeutic use | |
| 650 | 4 | |a Adrenergic beta-Antagonists - therapeutic use | |
| 650 | 4 | |a Blood Pressure - drug effects | |
| 650 | 4 | |a Heart Failure - drug therapy | |
| 650 | 4 | |a Imidazoles - therapeutic use | |
| 650 | 4 | |a Hypertension - complications | |
| 650 | 4 | |a Angiotensin-Converting Enzyme Inhibitors - therapeutic use | |
| 650 | 4 | |a Hypertension - physiopathology | |
| 650 | 4 | |a Heart Failure - complications | |
| 700 | 1 | |a Shiba, Nobuyuki |4 oth | |
| 700 | 1 | |a Takahashi, Jun |4 oth | |
| 700 | 1 | |a Miyata, Satoshi |4 oth | |
| 700 | 1 | |a Nochioka, Kotaro |4 oth | |
| 700 | 1 | |a Miura, Masanobu |4 oth | |
| 700 | 1 | |a Takada, Tsuyoshi |4 oth | |
| 700 | 1 | |a Saga, Chiharu |4 oth | |
| 700 | 1 | |a Shinozaki, Tsuyoshi |4 oth | |
| 700 | 1 | |a Sugi, Masafumi |4 oth | |
| 700 | 1 | |a Nakagawa, Makoto |4 oth | |
| 700 | 1 | |a Sekiguchi, Nobuyo |4 oth | |
| 700 | 1 | |a Komaru, Tatsuya |4 oth | |
| 700 | 1 | |a Kato, Atsushi |4 oth | |
| 700 | 1 | |a Fukuchi, Mitsumasa |4 oth | |
| 700 | 1 | |a Nozaki, Eiji |4 oth | |
| 700 | 1 | |a Hiramoto, Tetsuya |4 oth | |
| 700 | 1 | |a Inoue, Kanichi |4 oth | |
| 700 | 1 | |a Goto, Toshikazu |4 oth | |
| 700 | 1 | |a Ohe, Masatoshi |4 oth | |
| 700 | 1 | |a Tamaki, Kenji |4 oth | |
| 700 | 1 | |a Ibayashi, Setsuro |4 oth | |
| 700 | 1 | |a Ishide, Nobumasa |4 oth | |
| 700 | 1 | |a Maruyama, Yukio |4 oth | |
| 700 | 1 | |a Tsuji, Ichiro |4 oth | |
| 700 | 1 | |a Shimokawa, Hiroaki |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t European heart journal |d Oxford : Oxford. Univ. Press, 1980 |g 36(2015), 15, Seite 915 |w (DE-627)130396907 |w (DE-600)603098-1 |w (DE-576)015899667 |x 0195-668X |7 nnns |
| 773 | 1 | 8 | |g volume:36 |g year:2015 |g number:15 |g pages:915 |
| 856 | 4 | 1 | |u http://dx.doi.org/10.1093/eurheartj/ehu504 |3 Volltext |
| 856 | 4 | 2 | |u http://www.ncbi.nlm.nih.gov/pubmed/25637937 |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a SYSFLAG_A | ||
| 912 | |a GBV_OLC | ||
| 912 | |a SSG-OLC-PHA | ||
| 912 | |a SSG-OLC-DE-84 | ||
| 912 | |a GBV_ILN_2414 | ||
| 912 | |a GBV_ILN_4219 | ||
| 951 | |a AR | ||
| 952 | |d 36 |j 2015 |e 15 |h 915 | ||