Role transition in ASCOT-BPLA trial

Atenolol decreased more than Amlodipine. Thiazide increased as Perindopril increased. The main opponent of perindopril in ASCOT seemed to be bendroflumethiazide.



ASCOT BPLA: Lancet 2005;366:895-906. PMID:16154016

Comparison between ASCOT-BPLA & ADVANCE

ASCOT BPLA
Duration 5.5years, 19257 people, 27% DM case
BP goal: non-DM 140/90, DM 130/80 =>average goal 137.3/77.3
Placebo BP start 163.9/94·5-> end 137.7/79.2 death 9%
Drug escalating, BP difference: 2.7/1.9mmHg
Hazard ratio: death (All 0.89 CV 0.76), Stroke 0.77
ADVANCE
Duration 4.3years, 11140 people, 100% DM case
BP goal: in discretion of physician (? 140/90)
Placebo BP start 145/81 -> end 140/73 death 8.5%
All medicated in active group, BP difference: 5.6/2.2mmHg
Hazard ratio: death (All 0.86, CV 0.82), Macro+micro 0.91

ASCOT BPLA: Lancet 2005; 366: 895–906. PMID:16154016
ADVANCE: Lancet. 2007 Sep 8;370(9590):829-40. PMID:17765963

Comment: ADVANCE lowered double SBP, but seems didn't have double benefit of ASCOT