当前位置： SCI文献检索 > JOURNAL OF HYPERTENSION期刊下所有文献 > Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk.

Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk.

Abstract：

BACKGROUND:The effects of aspirin in subjects without cardiovascular disease are controversial. In the intensively treated patients of the Hypertension Optimal Treatment (HOT) Study, randomization to low-dose aspirin (75 mg daily) versus placebo significantly reduced cardiovascular events (-15%) and myocardial infarction (-36%), but increased major bleedings (+65%). The present analyses of HOT Study data aim at identifying subgroups of hypertensives with different benefit-to-harm ratios from aspirin, in order to provide recommendations about the use of aspirin in hypertension. METHODS:The 18 790 hypertensive patients (aspirin 9399, placebo 9391; average treatment duration 3.8 years) were stratified for global cardiovascular risk and for individual risk factors. Subgroup-treatment interaction analyses (end points: cardiovascular events, myocardial infarction, major bleedings) were performed by a Cox proportional hazard model. Relative and absolute benefits and harms were calculated. RESULTS:Interaction analyses indicated that of all subgroups, only patients with serum creatinine > 1.3 mg/dl had a significantly greater reduction of cardiovascular events and myocardial infarction (-13 and -7/1000 patient-years), while risk of bleeding was not significantly different between subgroups. In addition to patients with higher creatinine, a favourable balance between benefit and harm of aspirin was found in subgroups of patients at higher global baseline risk and baseline systolic pressure > or = 180 or diastolic pressure > or = 107 mmHg. CONCLUSIONS:Low-dose aspirin should be recommended to well-treated hypertensive patients with even moderate increase in serum creatinine. Aspirin may also be recommended in well-treated hypertensives at higher global cardiovascular risk or higher initial blood pressures.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

Zanchetti A,Hansson L,Dahlöf B,Julius S,Ménard J,Warnold I,Wedel H,HOT Study Group.

doi

10.1097/00004872-200211000-00031

subject

Has Abstract

pub_date

2002-11-01 00:00:00

pages

2301-7

issue

eissn

0263-6352

issn

1473-5598

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

在线工具

Benefit and harm of low-dose aspirin in well-treated hypertensives at different baseline cardiovascular risk.