Details

Autor(en) / Beteiligte

• Sakata, Yasuhiko
• Shiba, Nobuyuki
• Takahashi, Jun
• Miyata, Satoshi
• Nochioka, Kotaro
• Miura, Masanobu
• Takada, Tsuyoshi
• Saga, Chiharu
• Shinozaki, Tsuyoshi
• Sugi, Masafumi
• Nakagawa, Makoto
• Sekiguchi, Nobuyo
• Komaru, Tatsuya
• Kato, Atsushi
• Fukuchi, Mitsumasa
• Nozaki, Eiji
• Hiramoto, Tetsuya
• Inoue, Kanichi
• Goto, Toshikazu
• Ohe, Masatoshi
• Tamaki, Kenji
• Ibayashi, Setsuro
• Ishide, Nobumasa
• Maruyama, Yukio
• Tsuji, Ichiro
• Shimokawa, Hiroaki

Titel

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

Ist Teil von

• European heart journal, 2015-04, Vol.36 (15), p.915-923

Ort / Verlag

England: Oxford University Press

Erscheinungsjahr

2015

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• 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.