P-225: Predictors of one year blood pressure control and treatment resistance in the value trial

• Published in: American journal of hypertension 2002-04, Vol.15 (S3), p.111A-111A
• Main Authors: Julius, Stevo, Bach, Doris, Kjeldsen, Sverre E., Brunner, Hans R., Hansson, Lennart, Henis, Marc, Ekman, Steffan, Laragh, John H., McInnes, Gordon T., Smith, Beverly, Weber, Michael A., Zanchetti, Alberto
• Format: Article
• Language: English
• Subjects: Amlodipine; Blood Pressure Control; Valsartan
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(02)02576-1

The Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) Trial is testing the hypothesis that for the same level of BP control, the AT1-receptor blocker valsartan reduces serious cardiac events by 15% compared to the CCB amlodipine. VALUE is a double-blind, randomized, in 31 countries, prospective trial of 15314 previously treated (92%) or untreated hypertensives, 42.4% women, mean age 67.2 yrs, BMI 28.6 kg/m2, coronary heart disease (CHD) in 45.8%, high cholesterol in 32.9%, type-2 diabetes mellitus (DM) in 31.7% and 24.0% smokers. The primary endpoint is expected in 1450 pts. in 2-3 yrs. The aim of this analysis is to identify predictors of 1-year BP control and resistance to treatment in the VALUE population. BP decreased from 154.7/87.6 at randomization to 141.3/80.9 mmHg at 12 months and control rate 160 and/or >100 mmHg at the highest drug titration step (step 5). Characteristics are shown in the accompanying table. The odds of being controlled were up 23% in pts. with controlled SBP at baseline, decreased by 3% per mmHg rise in baseline pulse pressure (PP) and 2% per year of age, were 23% less in DM, 25% higher in USA, 85% higher in Asians, 25% higher in CHD and 34% higher in smokers. In the “best” model, pts. not in USA (RR 1.58, p