Abstract |
The CSPPT (China Stroke Primary Prevention Trial) demonstrated a significant risk reduction of first stroke in hypertensive patients treated with enalapril plus folic acid compared with those with enalapril alone, but the lifetime stroke-free survival associated with the treatment is unknown. By establishing adjusted models for competing risks and an age-based time scale using data from 19 053 participants of the CSPPT, we estimated lifetime incremental stroke-free survival for enalapril- folic acid versus enalapril alone. Compared with enalapril alone, the enalapril plus folic acid treatment projected a mean lifetime stroke-free survival gain of 1.75 months, with an interquartile range from 0.73 to 2.39 months and the maximum gain up to 12.95 months. Subgroup analyses showed greater gain in stroke-free survival in younger, male patients, those with lower baseline folate levels, higher baseline systolic blood pressure, higher baseline total cholesterol and blood glucose, and with MTHFR ( methylenetetrahydrofolate reductase) C677T CT or TT genotype. Overall, besides significant benefit in certain subgroups, enalapril plus folic acid treatment for hypertensive patients is associated with a modest gain in lifetime stroke-free survival, compared with enalapril alone.
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Authors | Tiantian Zhang, Tengfei Lin, Yang Wang, Binyan Wang, Xianhui Qin, Feng Xie, Yimin Cui, Yong Huo, Xiaobin Wang, Zugui Zhang, Jie Jiang |
Journal | Hypertension (Dallas, Tex. : 1979)
(Hypertension)
Vol. 75
Issue 2
Pg. 339-346
(02 2020)
ISSN: 1524-4563 [Electronic] United States |
PMID | 31865785
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Vitamin B Complex
- Folic Acid
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Topics |
- Aged
- Blood Pressure
(physiology)
- Disease-Free Survival
- Double-Blind Method
- Female
- Folic Acid
(administration & dosage)
- Follow-Up Studies
- Humans
- Hypertension
(complications, drug therapy, physiopathology)
- Male
- Middle Aged
- Primary Prevention
(methods)
- Stroke
(etiology, prevention & control)
- Treatment Outcome
- Vitamin B Complex
(administration & dosage)
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