(Hypertension. 2001;37:12.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
Baseline Characteristics and Early Blood Pressure Control in the CONVINCE Trial
From the Department of Preventive Medicine (H.R.B., W.J.E.), Rush-Presbyterian-St Luke’s Medical Center, Chicago, Ill; Division of Biostatistics (J.D.N., G.G., P.G.), The University of Minnesota (Minneapolis); The University of Minnesota (R.H.G.) (Minneapolis); Department of Geriatrics (L.H.), University of Uppsala, Uppsala, Sweden; Centre Hospitalier Universitaire de Québec (Y.L.), Québec, Canada; Department of Medicine (J.M.), The Massachusetts General Hospital, Boston, Mass; John Radcliffe Hospital and Department of Medicine (P.S.), Oxford University, Oxford, UK; Department of Medicine, The Brookdale Hospital, and The State University of New York (M.A.W.) (Brooklyn); Section of Hypertension and Clinical Pharmacology, Department of Medicine (W.B.W.), The University of Connecticut School of Medicine (Farmington); Brigham and Women’s Hospital and The Harvard Medical School (G.W.), Boston, Mass; Statistics · Collaborative (J.W.), Washington, DC; Ospedale Maggiore and Centro Auxologico Italiano and the University of Milan (A.Z.), Milan, Italy; and Clinical Research (T.D.F., R.J.A.), Searle Laboratories, Skokie, Ill.
Correspondence to Henry R. Black, MD, Roberts Professor and Chairman, Department of Preventive Medicine, Rush-Presbyterian-St Luke’s Medical Center, 1700 West Van Buren St, Suite 470, Chicago, IL 60612.
Abstract—Blood pressure (BP) control rates around the world are suboptimal. Part 2 of the National Health and Nutrition Educational Survey (NHANES) III indicates that only 27.4% of hypertensive Americans aged 18 to 74 years have a BP of <140/90 mm Hg. We wanted to assess BP control during the first 2 years and to describe the baseline characteristics of patients enrolled in the Controlled ONset Verapamil INvestigation of Cardiovascular Endpoints (CONVINCE) Study, an international clinical trial that compares outcomes in hypertensive patients randomized to initial treatment with either controlled-onset extended-release verapamil or the investigator’s choice of atenolol or hydrochlorothiazide. At randomization, BP was <140/90 mm Hg in only 20.3% of the 16 602 subjects (average±SD age 65.6±7.4 years; 56% women, 84% white/7% black/7% Hispanic). The average BP at enrollment was 148/85 mm Hg for patients taking BP medications (n=13 879) and 161/94 mm Hg for previously untreated patients (n=2723). After medication titration, with a transtelephonic computer that recommended an increase in the dose or number of antihypertensive agents whenever the BP was 140/90 mm Hg, 84.8% of the subjects attained the goal BP. During 2 years of treatment, BP control was maintained in 67% to 69% of the subjects (69% to 71% for systolic BP of <140 mm Hg and 90% for diastolic BP of <90 mm Hg). These data suggest that the control of systolic BP is more difficult than the control of diastolic BP. The US national goal of having 50% of hypertensives with a BP of <140/90 mm Hg may be achievable if a forced titration strategy is used. Interested investigators, free care and medications, and well-educated subjects may make the attainment of such a goal easier in the CONVINCE study than in the general population.
Key Words: clinical trials • verapamil • atenolol • hydrochlorothiazide
This article has been cited by other articles:
 |
|
 |
|
  B. L. Carter Antihypertensive Prescribing: Do We Have Reason to Celebrate? Hypertension, November 1, 2006; 48(5): 816 - 817. [Full Text] [PDF]
|
|
|
|
|
|
E. C. Okonofua, K. N. Simpson, A. Jesri, S. U. Rehman, V. L. Durkalski, and B. M. Egan Therapeutic Inertia Is an Impediment to Achieving the Healthy People 2010 Blood Pressure Control Goals Hypertension, March 1, 2006; 47(3): 345 - 351. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Wang and R. S. Vasan Epidemiology of Uncontrolled Hypertension in the United States Circulation, September 13, 2005; 112(11): 1651 - 1662. [Full Text] [PDF]
|
|
|
|
 |
|
 J. W Olin Masterclass series in peripheral arterial disease: Hypertension and peripheral arterial disease Vascular Medicine, August 1, 2005; 10(3): 241 - 246. [PDF]
|
|
|
|
 |
|
 A. V. Chobanian, G. L. Bakris, H. R. Black, W. C. Cushman, L. A. Green, J. L. Izzo Jr, D. W. Jones, B. J. Materson, S. Oparil, J. T. Wright Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report JAMA, May 21, 2003; 289(19): 2560 - 2571. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. R. Black, W. J. Elliott, G. Grandits, P. Grambsch, T. Lucente, W. B. White, J. D. Neaton, R. H. Grimm Jr, L. Hansson, Y. Lacourciere, et al. Principal Results of the Controlled Onset Verapamil Investigation of Cardiovascular End Points (CONVINCE) Trial JAMA, April 23, 2003; 289(16): 2073 - 2082. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. M. Egan, D. T. Lackland, and N. E. Cutler Awareness, Knowledge, and Attitudes of Older Americans About High Blood Pressure: Implications for Health Care Policy, Education, and Research Arch Intern Med, March 24, 2003; 163(6): 681 - 687. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A Staessen, J.-G. Wang, and W. H Birkenhager Outcome beyond blood pressure control? Eur. Heart J., March 2, 2003; 24(6): 504 - 514. [Full Text] [PDF]
|
|
|
|
|
|
G. M. Singer, M. Izhar, and H. R. Black Goal-Oriented Hypertension Management: Translating Clinical Trials to Practice Hypertension, October 1, 2002; 40(4): 464 - 469. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Benetos, F. Thomas, K. Bean, S. Gautier, H. Smulyan, and L. Guize Prognostic Value of Systolic and Diastolic Blood Pressure in Treated Hypertensive Men Arch Intern Med, March 11, 2002; 162(5): 577 - 581. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-J. Mourad, J. Blacher, P. Blin, and U. Warzocha Conventional Antihypertensive Drug Therapy Does Not Prevent the Increase of Pulse Pressure With Age Hypertension, October 1, 2001; 38(4): 958 - 961. [Abstract] [Full Text] [PDF]
|
|