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Efficacy of antihypertensive treatment for target organ protection in patients with masked hypertension (ANTI-MASK): a multicentre, double-blind, placebo-controlled trial

eClinicalMedicine, ISSN: 2589-5370, Vol: 74, Page: 102736
2024
  • 2
    Citations
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    Usage
  • 7
    Captures
  • 4
    Mentions
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    Social Media
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  • Citations
    2
  • Captures
    7
  • Mentions
    4
    • News Mentions
      4
      • News
        4

Most Recent News

Data on Left Ventricular Hypertrophy Detailed by Researchers at Shanghai Jiao Tong University [Efficacy Fi Cacy of Antihypertensive Treatment for Target Organ Protection In Patients With Masked Hypertension (Anti-mask): a Multicentre, ...]

2024 AUG 16 (NewsRx) -- By a News Reporter-Staff News Editor at Disease Prevention Daily -- Data detailed on Heart Disorders and Diseases - Left

Article Description

Masked hypertension is associated with target organ damage (TOD) and adverse health outcomes, but whether antihypertensive treatment improves TOD in patients with masked hypertension is unproven. In this multicentre, randomised, double-blind, placebo-controlled trial at 15 Chinese hospitals, untreated outpatients aged 30–70 years with an office blood pressure (BP) of <140/<90 mm Hg and 24-h, daytime or nighttime ambulatory BP of ≥130/≥80, ≥135/≥85, or ≥120/≥70 mm Hg were enrolled. Patients had ≥1 sign of TOD: electrocardiographic left ventricular hypertrophy (LVH), brachial-ankle pulse wave velocity (baPWV) ≥1400 cm/s, or urinary albumin-to-creatinine ratio (ACR) ≥3.5 mg/mmol in women and ≥2.5 mg/mmol in men. Exclusion criteria included secondary hypertension, diabetic nephropathy, serum creatinine ≥176.8 μmol/L, and cardiovascular disease within 6 months of screening. After stratification for centre, sex and the presence of nighttime hypertension, eligible patients were randomly assigned (1:1) to receive antihypertensive treatment or placebo. Patients and investigators were masked to group assignment. Active treatment consisted of allisartan starting at 80 mg/day, to be increased to 160 mg/day at month 2, and to be combined with amlodipine 2.5 mg/day at month 4, if the ambulatory BP remained uncontrolled. Matching placebos were used likewise in the control group. The primary endpoint was the improvement of TOD, defined as normalisation of baPWV, ACR or LVH or a ≥20% reduction in baPWV or ACR over the 48-week follow-up. The intention-to-treat analysis included all randomised patients, the per-protocol analysis patients who fully adhered to the protocol, and the safety analysis all patients who received at least one dose of the study medication. This study is registered with ClinicalTrials.gov, NCT02893358. Between February 14, 2017, and October 31, 2020, 320 patients (43.1% women; mean age ± SD 53.7 ± 9.7 years) were enrolled. Baseline office and 24-h BP averaged 130 ± 6.0/81 ± 5.9 mm Hg and 136 ± 8.6/84 ± 6.1 mm Hg, and the prevalence of elevated baPWV, ACR and LVH were 97.5%, 12.5%, and 7.8%, respectively. The 24-h BP decreased on average (±SE) by 10.1 ± 0.9/6.4 ± 0.5 mm Hg in 153 patients on active treatment and by 1.3 ± 0.9/1.0 ± 0.5 mm Hg in 167 patients on placebo. Improvement of TOD occurred in 79 patients randomised to active treatment and in 49 patients on placebo: 51.6% (95% CI 43.7%, 59.5%) versus 29.3% (22.1, 36.5%; p < 0.0001). Per-protocol and subgroup analyses were confirmatory. Adverse events were generally mild and occurred in 38 (25.3%) and 43 (26.4%) patients randomised to active treatment and placebo, respectively (p = 0.83). Our results suggest that antihypertensive treatment improves TOD in patients with masked hypertension, highlighting the need of treatment. However, the long-term benefit in preventing cardiovascular complications still needs to be established. Salubris China.

Bibliographic Details

Jian Feng Huang; Dong Yan Zhang; De Wei An; Ming Xuan Li; Chang Yuan Liu; Xin Chen; Jan A. Staessen; Ji Guang Wang; Yan Li; Ying Qing Feng; Qi Dong Zheng; Yi Qing Zhang; Gui Li Chang; Zhe Hu; Xi Da Li; Can Liu; Jia Yi Huang; Yu Ling Yu; Yi Yun Wang; Xue Ning Zhang; Jing Yu; Rui Xin Ma; Heng Xia Liu; Xiao Ping Chen; Qing Tao Meng; Zhi Peng Zhang; Yu Dou; Mei Yu Zhu; Wen Juan Wang; Li Li Zhu; Min Zhang; Yi Nong Jiang; Yan Lu; Wei Yu; Xiao Ling Xu; Qiu Yan Dai; Yu Feng Zhu; Hui Jie Zhang; Yu Zhang; Jin Shun Zhang; Pei Li Bu; Ling Xin Liu; Jian Jun Mu; Jing Tao Xu; Yue Yuan Liao; Hao Guo; Xin Yue Liang

Elsevier BV

Medicine

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