Published online before print July 24, 2006, doi: 10.1161/01.HYP.0000236117.13311.0f
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(Hypertension. 2006;48:362.)
© 2006 American Heart Association, Inc.
Editorial Commentaries |
The Valsartan Antihypertensive Long-Term Use Evaluation Trial
A Study in Contrasts
From the Division of Nephrology, Virginia Commonwealth University Health System, Richmond.
Correspondence to Domenic A. Sica, Division of Nephrology, Box 980160, MCV Station, 1101 East Marshall St, Sanger Hall-Room 8-062, Virginia Commonwealth University Health System, Richmond, VA 23298-0160. E-mail dsica@hsc.vcu.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
The Valsartan Antihypertensive Long-Term Use Evaluation (VALUE) trial was designed to test the theory in hypertensive patients determined to be at high cardiovascular risk that, for the same level of blood pressure (BP) control, valsartan would reduce cardiac morbidity and mortality more so than amlodipine. The noise level about this trial was high in the months leading up to the release of its findings in 2004.1 Shortly after its publication, however, the preceding din became barely audible, particularly with regard to the usual deluge of poststudy publications and, thus, the sway of positive study results (or not) to drive publication numbers for an outcomes study.2 As an example of this, the Losartan Intervention for End-Points (LIFE) study was positive on several accounts, and, on a careful review of PubMed citations, it was found to have generated 105 original publications in indexed journals through June 2006, whereas, to date, there have been a mere handful of original publications from the VALUE trial.
The VALUE trial fell short of being able to test its proposed hypothesis, because the prerequisite of equal BP pressure reduction between therapies was not realized. Not surprisingly, a significant BP difference in favor of amlodipine existed, particularly in the early months of the trial. This failure to achieve equivalent levels of BP reduction, in part, was because of the mistaken belief that angiotensin-receptor blocker (ARB) monotherapy, and in this case valsartan, would reduce BP equally as well as amlodipine in a preponderance of high-risk subjects. In the current
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