Author(s): Schrader J, Lüders S, Kulschewski A, Hammersen F, Plate K, et al.
Background and purpose:In hypertensive stroke patients, for the same level of blood pressure control, eprosartan will be more effective than nitrendipine in reducing cerebrovascular and cardiovascular morbidity and mortality.
Methods:A total of 1405 well-defined, high-risk hypertensives with cerebral event during the last 24 months (proven by cerebral computed tomography scan or nuclear magnetic resonance) were randomized to eprosartan or nitrendipine (mean follow-up 2.5 years). Primary end point was the composite of total mortality and all cardiovascular and cerebrovascular events, including all recurrent events.
Results:Randomization was successful without significant differences in the baseline characteristics. Blood pressure was reduced to a comparable extent without any significant differences between the 2 groups during the whole study period (150.7/84 mm Hg and 152.0/87.2 mm Hg with eprosartan and nitrendipine therapy to 137.5/80.8 mm Hg and 136.0/80.2 mm Hg, respectively, confirmed by ambulatory blood pressure monitoring). Moreover, already after 3 months, normotensive mean values were achieved, and 75.5% reached values <140/90 mm Hg with the eprosartan regimen and 77.7% with the nitrendipine regimen. During follow-up, in total, 461 primary events occurred: 206 eprosartan and 255 nitrendipine (incidence density ratio [IDR], 0.79; 95% CI, 0.66 to 0.96; P=0.014). Cardiovascular events were: 77 eprosartan and 101 nitrendipine (IDR, 0.75; 95% CI, 0.55 to 1.02; P=0.06); cerebrovascular events: 102 eprosartan and134 nitrendipine (IDR, 0.75; 95% CI, 0.58 to 0.97; P=0.03).
Conclusions:The Morbidity and Mortality After Stroke, Eprosartan Compared With Nitrendipine for Secondary Prevention (MOSES) study was the first to compare an angiotensin II type 1 receptor antagonist with a calcium antagonist in secondary stroke prevention. In these high-risk hypertensive stroke patients, an early normotensive and comparable blood pressure was achieved. The combined primary end point was significantly lower in the eprosartan group.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/15879332
Author(s): Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R
Author(s): Dent J, El-Serag HB, Wallander MA, Johansson S
Author(s): Alberts MJ
Author(s): Ruszniewski P, Soufflet C, Barthélémy P
Author(s): Leys D, Balucani C, Cordonnier C
Author(s): Jones R, Junghard O, Dent J, Vakil N, Halling K, et al.
Author(s): Ponce J, Garrigues V, Agréus L, Tabaglio E, Gschwantler M, et al.
Author(s): Jonasson C, Moum B, Bang C, Andersen KR, Hatlebakk JG
Author(s): Furukawa N, Iwakiri R, Koyama T, Okamoto K, Yoshida T, et al.
Author(s): Ercelep OB, Caglar E, Dobrucali A
Author(s): Niigaki M, Adachi K, Hirakawa K, Furuta K, Kinoshita Y
Author(s): Qureshi AI, Sapkota BL
Author(s): Horikawa A, Ishii-Nozawa R, Ohguro M, Takagi S, Ohtuji M, et al.
Author(s): Miwa H, Hongo M, Kusano M, J-FAST Group
Author(s): Brzozowski T, Ptak-Belowska A, Kwiecien S, Krzysiek-Maczka G, Strzalka M, et al.