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4 results on '"Devereaux, RB"'

1. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis

Author

Adler, A, Agodoa, L, Algra, A, Asselbergs, FW, Beckett, NS, Berge, E, Black, H, Brouwers, FPJ, Brown, M, Bulpitt, CJ, Byington, RP, Chalmers, J, Cushman, WC, Cutler, J, Davis, BR, Devereaux, RB, Dwyer, J, Estacio, R, Fagard, R, Fox, K, Fukui, T, Gupta, AK, Holman, RR, Imai, Y, Ishii, M, Julius, S, Kanno, Y, Kjeldsen, SE, Kostis, J, Kuramoto, K, Lanke, J, Lewis, E, Lewis, JB, Lievre, M, Lindholm, LH, Lueders, S, MacMahon, S, Mancia, G, Matsuzaki, M, Mehlum, MH, Nissen, S, Ogawa, H, Ogihara, T, Ohkubo, T, Palmer, CR, Patel, A, Pepine, CJ, Pfeffer, MA, Pitt, B, Poulter, NR, Rakugi, H, Reboldi, G, Reid, C, Remuzzi, G, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, JA, Suzuki, H, Thijs, L, Ueshima, K, Umemoto, S, van Gilst, WH, Verdecchia, P, Wachtell, K, Whelton, P, Wing, L, Woodward, M, Yui, Y, Yusuf, S, Zanchetti, A, Zhang, ZY, Anderson, C, Baigent, C, Brenner, BM, Collins, R, de Zeeuw, D, Lubsen, J, Malacco, E, Neal, B, Perkovic, V, Rodgers, A, Rothwell, P, Salimi-Khorshidi, G, Sundström, J, Turnbull, F, Viberti, G, Wang, J, Adler, A, Agodoa, L, Algra, A, Asselbergs, FW, Beckett, NS, Berge, E, Black, H, Brouwers, FPJ, Brown, M, Bulpitt, CJ, Byington, RP, Chalmers, J, Cushman, WC, Cutler, J, Davis, BR, Devereaux, RB, Dwyer, J, Estacio, R, Fagard, R, Fox, K, Fukui, T, Gupta, AK, Holman, RR, Imai, Y, Ishii, M, Julius, S, Kanno, Y, Kjeldsen, SE, Kostis, J, Kuramoto, K, Lanke, J, Lewis, E, Lewis, JB, Lievre, M, Lindholm, LH, Lueders, S, MacMahon, S, Mancia, G, Matsuzaki, M, Mehlum, MH, Nissen, S, Ogawa, H, Ogihara, T, Ohkubo, T, Palmer, CR, Patel, A, Pepine, CJ, Pfeffer, MA, Pitt, B, Poulter, NR, Rakugi, H, Reboldi, G, Reid, C, Remuzzi, G, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, JA, Suzuki, H, Thijs, L, Ueshima, K, Umemoto, S, van Gilst, WH, Verdecchia, P, Wachtell, K, Whelton, P, Wing, L, Woodward, M, Yui, Y, Yusuf, S, Zanchetti, A, Zhang, ZY, Anderson, C, Baigent, C, Brenner, BM, Collins, R, de Zeeuw, D, Lubsen, J, Malacco, E, Neal, B, Perkovic, V, Rodgers, A, Rothwell, P, Salimi-Khorshidi, G, Sundström, J, Turnbull, F, Viberti, G, and Wang, J

Abstract

Background: The effects of pharmacological blood pressure lowering at normal or high-normal blood pressure ranges in people with or without pre-existing cardiovascular disease remains uncertain. We analysed individual participant data from randomised trials to investigate the effects of blood pressure lowering treatment on the risk of major cardiovascular events by baseline levels of systolic blood pressure. Methods: We did a meta-analysis of individual participant-level data from 48 randomised trials of pharmacological blood pressure lowering medications versus placebo or other classes of blood pressure-lowering medications, or between more versus less intensive treatment regimens, which had at least 1000 persons-years of follow-up in each group. Trials exclusively done with participants with heart failure or short-term interventions in participants with acute myocardial infarction or other acute settings were excluded. Data from 51 studies published between 1972 and 2013 were obtained by the Blood Pressure Lowering Treatment Trialists' Collaboration (Oxford University, Oxford, UK). We pooled the data to investigate the stratified effects of blood pressure-lowering treatment in participants with and without prevalent cardiovascular disease (ie, any reports of stroke, myocardial infarction, or ischaemic heart disease before randomisation), overall and across seven systolic blood pressure categories (ranging from <120 to ≥170 mm Hg). The primary outcome was a major cardiovascular event (defined as a composite of fatal and non-fatal stroke, fatal or non-fatal myocardial infarction or ischaemic heart disease, or heart failure causing death or requiring admission to hospital), analysed as per intention to treat. Findings: Data for 344 716 participants from 48 randomised clinical trials were available for this analysis. Pre-randomisation mean systolic/diastolic blood pressures were 146/84 mm Hg in participants with previous cardiovascular disease (n=157 728) and 157/89 m

Published
2021

2. Investigating the stratified efficacy and safety of pharmacological blood pressure-lowering: an overall protocol for individual patient-level data meta-analyses of over 300 000 randomised participants in the new phase of the Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC)

Author

Rahimi, K, Canoy, D, Nazarzadeh, M, Salimi-Khorshidi, G, Woodward, M, Teo, K, Davis, BR, Chalmers, J, Pepine, CJ, Agodoa, L, Algra, A, Asselbergs, FW, Beckett, N, Berge, E, Black, H, Brouwers, FPJ, Brown, M, Bulpitt, CJ, Byington, B, Cutler, J, Devereaux, RB, Dwyer, D, Fagard, R, Fox, K, Fukui, T, Gupta, AJ, Holman, RR, Imai, Y, Ishii, M, Julius, S, Kanno, Y, Kjeldsen, SE, Kostis, J, Kuramoto, K, Lanke, J, Lewis, E, Lievre, M, Lindholm, LH, Lueders, S, MacMahon, S, Matsuzaki, M, Mehlum, MH, Nissen, S, Ogawa, H, Othisgihara, T, Ohkubo, T, Palmer, C, Patel, A, Pepine, C, Pfeffer, M, Poulter, NR, Rakugi, H, Remuzzi, G, Ruggenenti, P, Saruta, T, Schrader, J, Schrier, R, Sever, P, Sleight, P, Staessen, JA, Suzuki, H, Thijs, L, Ueshima, K, Umemoto, S, Van Gilst, WH, Verdecchia, P, Wachtell, K, Yui, Y, Yusuf, S, Baigent, C, Collins, R, De Zeeuw, D, Neal, B, Perkovic, V, Rahman, M, Remme, WJ, Rodgers, A, Sundstrom, J, Turnbull, F, Foundation for Circulatory Health, Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), and Staessen, Jan

Subjects
medicine.medical_specialty, Epidemiology, Disease, REGIMENS, 030204 cardiovascular system & hematology, Research Support, Phase (combat), 03 medical and health sciences, Medicine, General & Internal, 0302 clinical medicine, General & Internal Medicine, Diabetes mellitus, Protocol, medicine, Journal Article, Humans, 030212 general & internal medicine, Intensive care medicine, Non-U.S. Gov't, Stroke, Antihypertensive Agents, Randomized Controlled Trials as Topic, RISK, Protocol (science), Medicine(all), Science & Technology, efficacy and safety of bp lowering treatment, HYPERTENSION, business.industry, Research Support, Non-U.S. Gov't, blood pressure, General Medicine, medicine.disease, PROSPECTIVELY-DESIGNED OVERVIEWS, MODEL, Treatment Outcome, MAJOR CARDIOVASCULAR EVENTS, Blood pressure, Patient level data, meta-analyses, Blood pressure lowering, business, Life Sciences & Biomedicine, Blood Pressure Lowering Treatment Trialists’ Collaboration
Abstract

IntroductionPrevious research from the Blood Pressure Lowering Treatment Trialists’ Collaboration (BPLTTC) and others has shown that pharmacological blood pressure (BP)- lowering substantially reduces the risk of major cardiovascular events, including ischaemic heart disease, heart failure and stroke. In this new phase, the aim is to conduct individual patient-level data (IPD) meta-analyses involving eligible BP-lowering randomised controlled trials (RCTs) to address uncertainties relating to efficacy and safety of BP-lowering treatment.Methods and analysisRCTs investigating the effect of pharmacological BP-lowering, with a minimum of 1000 patient-years of follow-up in each trial arm, are eligible. Our systematic review identified 100 potentially eligible trials. We requested their investigators/sponsors to contribute baseline, follow-up and outcomes data. As of June 2018, the collaboration has obtained data from 49 trials (n=315 046 participants), with additional data currently in the process of being transferred from four RCTs (n=34 642 participants). In addition, data harmonisation has commenced. Scientific activities of the collaboration are overseen by the Steering Committee with input from all collaborators. Detailed protocols for individual meta-analyses will be developed and registered on public platforms.Ethics and disseminationEthics approval has been obtained for this new and extended phase of the BPLTTC, the largest collaboration of de-identified IPD from RCTs. It offers an efficient and ethical manner of re-purposing existing data to answer clinically important questions relating to BP treatment as well as methodological questions relating to IPD meta-analyses. Among the immediate impacts will include reliable quantification of effects of treatment modifiers, such as baseline BP, age and prior disease, on both vascular and non-vascular outcomes. Analyses will further assess the impact of BP-lowering on important, but less well understood, outcomes, such as new-onset diabetes and renal disease. Findings will be published in peer-reviewed medical journals on behalf of the collaboration.

Published
2019

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