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anti hypertensive agents in hypertension for all type of patient, clinical trials results

aliskiren versus amlodipine
ACCELERATE, 2011
NCT00797862

versus
essential hypertension, were aged 18 years or older, and had systolic blood pressure between 150 and 180 mm Hg
aliskiren versus hydrochlorothiazide
Schmieder (vs HCTZ), 2009
aliskiren 300 mg
versus
hydrochlorothiazide 25 mg
patients with essential hypertension double blind
Follow-up duration: 20 weeks
aliskiren versus losartan
ALLAY, 2009
NCT00219141
aliskiren 300 mg
versus
losartan 100 mg
patients with hypertension, increased ventricular wall thickness, and body mass index >25 kg/m2open
Follow-up duration: 9 months
aliskiren versus placebo
AVOID, 2008
NCT00097955
aliskiren (150 mg daily for 3 months, followed by an increase in dosage to 300 mg daily for another 3 months
versus
placebo
patients with hypertension and type 2 diabetes with nephropathydouble blind
Follow-up duration: 6 months
15 countries
aliskiren versus ramipril
Andersen, 2008
aliskiren 150 mg (up to 300mg) daily
versus
ramipril 5 mg (up to 10mg) daily
double blind
Follow-up duration: 26 weeks
amlodipine versus atenolol
ASCOT-BPLA, 2005
amlodipine5–10 mg adding perindopril 4–8 mg as required
versus
atenolol 50–100 mg adding bendroflumethiazide 1·25–2·5 mg and potassium as required
patients with hypertension who were aged 40–79 years and had at least three other cardiovascular risk factors.ÿopen
Follow-up duration: 5.5 y
Nordic countries and UK
amlodipine versus chlorthalidone
ALLHAT (CCB vs diu), 2002
Amlodipine 2.5 to 10g/d , Amlodipine 2.5 to 10g/d , Amlodipine 2.5 to 10g/d , Amlodipine 2.5 to 10g/d
versus
chlorthalidone 12.5 to 25 mg/d
participants aged 55 years or older with hypertension and at least 1 other CHD risk factor Double aveugle
Follow-up duration: 4.9y
US
amlodipine versus lisinopril
ALLHAT (CCB vs ACEI), 2002
Amlodipine 2.5 to 10g/d , Amlodipine 2.5 to 10g/d , Amlodipine 2.5 to 10g/d
versus
lisinopril 10 to 40 mg/d
participants aged 55 years or older with hypertension and at least 1 other CHD risk factorDouble aveugle
Follow-up duration: 4.9y
US
amlodipine versus metoprolol
AASK (amlodipine vs metoprolol), 2002
Amlodipine 5-10 mg/d
versus
metoprolol 50-200 mg/d
African Americans aged 18 to 70 years with hypertensive renal disease (GFR, 20-65 mL/min per 1.73m2)
Follow-up duration: 3·0y
US
amlodipine versus placebo
IDNT (amlodipine vs pbo), 2001
Amlodipine 10mg/d
versus
placebo
hypertensive patients with nephropathy due to type 2 diabetesDouble blind
Follow-up duration: 2·6
amlodipine versus ramipril
AASK (amlodipine vs ramipril), 2002
Amlodipine 5-10 mg/d
versus
ramipril 2.5-10 mg/d
African Americans aged 18 to 70 years with hypertensive renal disease (GFR, 20-65 mL/min per 1.73m2) Double blind
Follow-up duration: 3·0
US
amlodipine plus benazepril versus hydrochlorothiazide plus benazepril
ACCOMPLISH, 2008
NCT00170950
benazepril 40mg plus amlodipine 5mg daily
versus
benazepril 40mg plus hydrochlorothiazide 12.5mg daily
patients with hypertension who were at high risk for cardiovascular eventsdouble blind
Follow-up duration: 36 months
US, Sweden, Norway, Denmark, Finland
ARBs versus control
Suzuki, 2008
ARBs (valsartan, candesartan, and losartan)
versus
no ARBs
patients with diabetes and chronic kidney disease on dialysisopen
atenolol versus bendroflumethiazide
MRC I (vs diuretics), 1985
Propranolol
versus
Bendroflumethiazide.
men and women aged 35-64 years with mild hypertension (diastolic pressure 90-109 mm Hgdouble blind
Follow-up duration: 5·5y
atenolol versus control
Coope, 1986
atenolol and bendrofluazide , Atenolol
versus
Open control
patients aged 60 to 79 years open
Follow-up duration: 4·4y
atenolol versus hydrochlorothiazide+amiloride
MRC old (vs diuretics), 1992
Atenolol
versus
Hydrochlorothiazide/amiloride
hypertensive patients aged 65-74double blind
Follow-up duration: 5·8y
UK
atenolol versus placebo
MRC I (vs placebo), 1985
Propranolol
versus
Placebo
men and women aged 35-64 yearswith mild hypertension (diastolic pressure 90-109 mm Hgdouble blind
Follow-up duration: 5.5y
MRC old (vs placebo), 1992
Atenolol
versus
Placebo
patients aged 65-74double blind
Follow-up duration: 5.8y
UK
Dutch TIA, 1993
Atenolol 50mg/d
versus
Placebo
aspirin-treated patients with transient ischemic attack or nondisabling ischemic stroke double blind
Follow-up duration: 2·6y
TEST, 1995
Atenolol
versus
Placebo
post stroke
Follow-up duration: 2·6y
candesartan versus amlodipine
CASE-J, 2008
candesartan-based regimen
versus
amlodipine-based regimen
high-risk Japanese hypertensive patientsopen (blinded assessment)
Follow-up duration: 3.2 years
Japan
candesartan versus control
Takahashi, 2006
candesartan
versus
control
patients on chronic haemodialysis in stable condition and with no clinical evidence of cardiac disorders open
Follow-up duration: 19.4 months
candesartan versus conventional treatment
E-COST, 2005
candesartan, 2 to 12 mg daily
versus
conventional antihypertensive drugs other than angiotensin converting enzyme inhibitors or ARBs
Japanese essential hypertensive subjects (sitting blood pressure 140-180/90-110 mmHg) aged 35-79 yearssingle-blind
Japan
E-COST-R, 2005
candesartan
versus
conventional treatment
hypertensive subjects 60 to 75 years old with non-diabetic chronic renal insufficiencyopen
HIJ-CREATE, 2009
angiotensin II receptor blocker-based therapy
versus
non-angiotensin II receptor blocker-based therapy
patients with angiographically documented coronary artery disease and hypertensionopen
Follow-up duration: 4.2 y (median)
Japan
candesartan versus hydrochlorothiazide
ALPINE, 2003
candesartan
versus
hydrochlorothiazide
newly detected hypertensivesdouble-blind
Follow-up duration: 1 year
Sweden
candesartan versus placebo
SCOPE, 2003
candesartan, 8–16 mg once daily (target 160/90)
versus
placebo
patients aged 70–89 years, with systolic blood pressure 160– 179 mmHg, and/or diastolic blood pressure 90–99 mmHg, and a Mini Mental State Examination (MMSE) test score > 24double-blind
Follow-up duration: 3.7 y (mean)
15 countries
captopril versus diuretic or beta-blocker
CAPPP, 1999
captopril 50mg/d
versus
beta-blocker (not specified) or diuretic (not specified)
Patients aged 25–66 years with a measured diastolic bloodpressure of 100 mm Hg or more on two occasionsOpen
Follow-up duration: 6.1 y
Sweden and Finland
UKPDS-HDS, 1998
captopril started at 25mg twice daily up to 50 mg twice dialy (target blood pressure of <150/<85 mmHG)
versus
atenolol started at 50mg daily up to 100mg if required(target blood pressure of <150/<85 mmHG)
HBP+DMOpen
Follow-up duration: 8·4 y
England, Scotland, and Northern Ireland
chlorthalidone versus placebo
SHEP-pilot, 1989
chlorthalidone
versus
placebo
elderly participants with untreated blood pressures of greater than 160/less than 90 mm Hg double blind
Follow-up duration: 2.8y
VA-NHLBI, 1977
chlorthalidone 50mg/d
versus
placebo
patients aged 21 to 50 years with diastolic BP between 85 to 105 mm HgDouble aveugle
Follow-up duration: 1.4 y
USA
SHEP, 1991
NCT00000514
chlorthalidone, 12.5 mg/d , chlorthalidone, 12.5 mg/d , chlorthalidone, 12.5 mg/d
versus
placebo
patients aged 60 years and above with Systolic BP between 160 and 219 mm Hg and diastolic BP less than 90 mm Hg Double blind
Follow-up duration: 4.4 y
deserpidine +methylclothiazide versus placebo
HSCS, 1974
deserpidine 1mg/d + methylclothiazide 10mg/d
versus
placebo
strokeDouble blind
Follow-up duration: 2.3y
USA
diltiazem versus diuretic or beta-blocker
NORDIL, 2000
diltiazem 180-360 daily
versus
beta-blocker (not specified) or diuretic (not specified)
hypertensive patients, aged 50–74 yearsOpen
Follow-up duration: up to 5 years
Norway, Sweden
diuretic and rauwolfia serpentina versus placebo
USPHS, 1977
diuretic and rauwolfia serpentina
versus
placebo
subjects, ages 21-55, with diastolic blood pressures between 90 and 115 mm Hg double blind
Follow-up duration: 7.0 y
enalapril versus diuretics
ANBP2, 2003
enalapril
versus
hydrochlorothiazide
subjects with hypertension 65 to 84 years open
Follow-up duration: 4.1 y
Australia
enalapril versus nisoldipine
ABCD (H), 1998
enalapril
versus
nisoldipine
patients with non-insulin-dependent diabetes and hypertensiondouble blind
Follow-up duration: 5·3 y
felopidine or israpidine versus diuretic or beta-blocker
STOP-2 (CCB vs diurectic or beta-blocker), 1999
felodipine 2·5 mg or isradipine 2–5 mg daily
versus
conventional antihypertensivedrugs (atenolol 50 mg, metoprolol 100 mg,pindolol 5 mg, or hydrochlorothiazide 25 mg plus amiloride2.5 mg daily
patients aged 70–84 years with hypertension (blood pressure >180 mm Hg systolic, >105 mm Hg diastolic, or both). Open
Follow-up duration: up to 6 years
High-dose diuretics versus beta-blockers
MRC (diu vs BB), 1985
High-dose diuretics
versus
ß-Blockers

Follow-up duration: 4.9y
High-dose diuretics versus control
HDFP, 1979
NCT00000485
High-dose diuretics
versus
Usual careb
persons with high blood pressure aged 30 to 69 years
Follow-up duration: 5 y
US
High-dose diuretics versus placebo
VA II, 1970
High-dose diuretics
versus
Placebo
male hypertensive patients with diastolic blood pressures averaging 90 to 114 mm Hg
Follow-up duration: 3.3y
VA-I, 1967
High-dose diuretics
versus
Placebo

Follow-up duration: 1.5y
Barraclough, 1973
High-dose diuretics
versus
Placebo

Follow-up duration: 2.0 y
hydrochlorothiazide + amiloride versus placebo
MRC old, 1992

versus
hypertensive patients aged 64-75
hydrochlorothiazide + triamterene versus placebo
Kuramoto, 1981
hydrochlorothiazide + triamterene
versus
placebo
patients over the age of 60 with sitting diastolic blood pressure on placebo treatment in the range 90-119 mm Hg and a systolic pressure in the range 160-239 mm Hgdouble blind
Follow-up duration: 4.0y
EWPHE, 1985
hydrochlorothiazide + triamterene , hydrochlorothiazide + triamterene
versus
placebo
patients over the age of 60 with sitting diastolic blood pressure on placebo treatment in the range 90-119 mm Hg and a systolic pressure in the range 160-239 mm Hg Double blind
Follow-up duration: 4.3 y
indapamide versus placebo
HYVET, 2008
NCT00122811
indapamide sustained release 1.5 mg/d + perindopril 2-4mg/d to obtain SBP<150 and DBP<80
versus
placebo
patients 80 years or older with persistent hypertension defined as a sustained systolic BP of 160 mm Hg or higherDouble blind
Follow-up duration: 1.8y (median)
Western and Eastern Europe, China, Australasia, and North Africa
PATS, 1995
indapamide 2.5 mg/d
versus
placebo
Double blind
Follow-up duration: 2y
China
irbesartan versus amlodipine
IDNT (irbesartan vs amlodipine), 2001
Irbesartan 300mg/d (with a target of 135/85)
versus
amlodipine 10mg/d (with a target of 135/85)
hypertensive patients with nephropathy due to type 2 diabetes double-blind
Follow-up duration: 2·6y
worldwide
irbesartan versus placebo
IDNT (irbesartan vs pbo), 2001
Irbesartan 300mg/d (target 135/85)
versus
placebo
hypertensive patients with nephropathy due to type 2 diabetesdouble-blind
Follow-up duration: 2.6 y
worldwide
IRMA 2, 2001
irbesartan 150 mg daily or 300 mg daily
versus
placebo
hypertensive patients with type 2 diabetes and microalbuminuriadouble-blind
Follow-up duration: 2 years
multinational
isradipine versus hydrochlorothiazide
MIDAS, 1996
isradipine 2.5-5.0 mg twice daily
versus
hydrochlorothiazide 12.5-25 mg Twice daily
HBP
Follow-up duration: 3y
lacidipine versus atenolol
ELSA, 2002
Lacidipine
versus
atenolol
patients with hypertensionDouble blind
Follow-up duration: 4·0y
lacidipine versus chlorthalidone
SHELL, 2003
lacidipine 4 mg/d
versus
chlorthalidone 12.5 mg/d
elderly patients with isolated systolic hypertension > or = 60 years
Follow-up duration: 3·6?y
LCZ696 versus placebo
Ruilope, 2010
LCZ696 for 8 weeks
versus
placebo
patients with mild to moderate hypertension double blind
Follow-up duration: 8 weeks
18 countries
lisinopril versus amlodipine
ALLHAT (ACEI vs amlodipine), 2002
Lisinopril 10 to 40 mg/d
versus
amlodipine 2.5 to 10 mg/d
participants aged 55 years or older with hypertension and at least 1 other CHD risk factDouble blind
Follow-up duration: 4.9 y
US
lisinopril versus diuretics
ALLHAT (ACEI vs chlorthalidone), 2002
lisinopril 10 to 40 mg/d
versus
chlorthalidone 12.5 to 25 mg/d
participants aged 55 years or older with hypertension and at least 1 other CHD risk factorDouble blind
Follow-up duration: 4·9 y
US
losartan versus atenolol
LIFE, 2002
losartan
versus
atenolol
patients aged 55–80 years, with previously treated or untreated hypertension (sitting blood pressure 160–200/95–115 mm Hg) and ECG signs of LVH.Double blind
Follow-up duration: 4.8 y (mean)
USA, Europe
losartan versus placebo
RENAAL, 2001
lLosartan 50 to 100 mg once daily
versus
placebo
patients with type 2 diabetes and nephropathydouble-blind
Follow-up duration: 3.4 years
nicardipine versus trichlormethiazide
NICS-EH, 1999
Nicardipine SR 20mg twice daily
versus
trichlormethiazide 2mg once daily
>=60 years of age with systolic blood pressure of 160 to 220 mm Hg and diastolic blood pressure <115 mm Hg Double blind
Follow-up duration: 4.5 years
nifedipine versus atenolol+chlorthalidone
Castel, 1994
Nifedipine 20mg/d
versus
Clonidine 0.15mg/d (n=61) or atenolol 100mg/d + chlorthalidone 25mg/d
nifedipine versus hydrochlorothiazide+amiloride
INSIGHT, 2000
nifedipine GITS 30mg/d
versus
hydrochlorothiazide 25mg/d + amiloride 2.5mg/d
HBP + RFDouble blind
Follow-up duration: at least 3 years
nitrendipine versus placebo
SYST-EUR, 1997
nitrendipine 10-40 mg daily , nitrendipine 10-40 mg daily
versus
placebo
HBP, >=60 years Double aveugle
Follow-up duration: 2·6y
23 countries across Europe
olmesartan 40 mg versus olmesartan 20 mg plus a calcium-channel blocker
OSCAR, 2011
NCT00134160
high-dose olmesartan 40 mg per day
versus
20-mg/day olmesartan comined with standard dose of amlodipine or azelnidipine
high-risk elderly Japanese hypertension patients
Japan
oxprenolol versus placebo
IPPPSH, 1985
Oxprenolol
versus
Placebo
men and women aged 40-64 years with uncomplicated essential hypertension (diastolic blood pressures 100-125 mmHg)Double blind
Follow-up duration: 4·0y
propranolol versus bendroflumethiazide
Berglund, 1986
Propranolol
versus
Bendroflumethiazide.
patients 21 to 70 years with essential hypertension (sitting diastolic blood pressures 100-120 mm Hg)
Follow-up duration: 10y
ramipril versus amlodipine
AASK (ramipril vs amlodipine), 2002
ramipril 2.5-10 mg/d
versus
amlodipine 5-10 mg/d
African Americans aged 18 to 70 years with hypertensive renal disease (GFR, 20-65 mL/min per 1.73 m(2))Double blind
Follow-up duration: 3·0 y
US
ramipril versus metoprolol
AASK (ramipril vs metoprolol), 2002
ramipril 2.5-10 mg/d
versus
metoprolol 50-200 mg/d
African Americans aged 18 to 70 years with hypertensive renal disease (GFR, 20-65 mL/min per 1.73 m(2))Double blind
Follow-up duration: 4·1 y
US
telmisartan versus enalapril
DETAIL, 2004
telmisartan 80 mg daily
versus
enalapril 20 mg daily
subjects with type 2 diabetes and early nephropathy double-blind
Follow-up duration: 5 year
telmisartan versus placebo
PROPHESS, 2008
NCT00153062
telmisartan 80 mg daily
versus
placebo
patients who recently had an ischemic strokedouble blind
Follow-up duration: 2.5 y
35 countries
thiazide diuretics versus control
Carter, 1970
thiazide
versus
?
Open
Follow-up duration: 3.6 y
NA
Oslo (Hegeland), 1980
step 1: hydrochlorothiazide 50mg/d, step 2: alpha methyldopa 250-500mg x2/d or propranolol 40-160mg x2/d,
versus
no treatment
men, aged 40 to 49 years, without target organ damage, with systolic blood pressures between 150 and 179 mm Hg and diastolic blood pressure below 110 mm HgOpen
Follow-up duration: 5.5 y
Oslo
ANBPS (Australian ), 1980
step 1:chlorothiazide 500 mg/d, step 2: chlorothoazide 500mg x2/d or methyldopa, propranolol, pindolol added, step 3: hydralazine or clonidine added
versus
placebo (without adjustement according to the BP!)
Double blind
Follow-up duration: 4 y
Australia
thiazide diuretics versus placebo
MCR 35-64 (diuretics vs pbo), 1985
bendrofluazide 10 mg/d (step 2: methyldopa)
versus
placebo
mild hypertension single blind
Follow-up duration: 4.9y
NA
valsartan versus amlodipine
VALUE, 2004
NCT00129233
valsartan based regimen
versus
amlodipine based regimen
patients, aged 50 years or older with treated or untreated hypertension and high risk of cardiac eventsDouble blind
Follow-up duration: 4.2 y (mean)
31 countries
various ACEI versus calcium-channel blocker
STOP-2 (ACEI vs felodipine or isradipine), 1999
Enalapril or lisinopril , enalapril 10 mg or lisinopril 10 mg daily
versus
felodipine 2.5 mg or isradipine 2-5 mg daily
patients aged 70-84 years with hypertension (blood pressure > or = 180 mm Hg systolic, > or = 105 mm Hg diastolic, or both) Open
Follow-up duration: 5·0 y
Sweden
various ACEI versus diuretic or beta-blocker
STOP 2 (ACEI vs diurectic or beta-blocker), 1999
enalapril 10 mg or lisinopril10 mg daily
versus
conventional antihypertensive drugs (atenolol 50 mg, metoprolol 100 mg, pindolol 5 mg, or hydrochlorothiazide 25 mg plus amiloride 2·5 mg daily)
patients aged 70–84 years with hypertension (blood pressure >180 mm Hg systolic, >105 mm Hg diastolic, or both).Open
Follow-up duration: 5.0 y
Sweden
various ACEI versus nifedipine
JMIC-B, 2002
ACE inhibitor
versus
nifedipine
HBP+CHDOpen
Follow-up duration: 3·0 y
Japan
various beta-blockers versus diuretics
Yurenev, 1992
hypotensive drugs including beta-blockers
versus
same combination of drugs including diuretics
hypertensive patients with different degrees of left ventricular hypertrophy (LVH)
Follow-up duration: 4·0y
HAPPHY, 1988
Atenolol, Metoprolol, Propranolol
versus
Hydrochlorothiazide, Bendroflumethiazide
Men aged 40-64 years with mild to moderate hypertension (diastolic blood pressure 100-130 mmHg) without previous CHD, strokeopen
Follow-up duration: 3·8y
various beta-blockers versus placebo
STOP, 1991
active antihypertensive therapy (Thiazide and amiloride or beta-blocker) , Atenolol, Metoprolol, Pindolol, HCTZ/Ami
versus
Placebo
hypertensive men and women aged 70-84 years Double blind
Follow-up duration: 2·1y
Swezden
verapamil versus atenolol
INVEST (Pepine), 2003
NCT00133692
verapamil sustained release 240mg/d
versus
atenolol 50mg/d
patients with hypertension and CAD
Follow-up duration: 2.7 y
14 countries
verapamil versus chlorthalidone
VHAS, 1998
verapamil SR 240 mg/d
versus
chlorthalidone 25mg/d
HBPOpen
Follow-up duration: 2 years
verapamil versus diuretic or beta-blocker
CONVINCE, 2003
controlled-onset extendedrelease(COER) verapamil 180mg/d
versus
hydrochlorothiazide 12.5 mg/d or atenolol 50 mg/d(investigator choice prior to randomization)
hypertension with 1 or more additional risk factors for cardiovascular diseaseDouble blind
Follow-up duration: 3 y
15 countries

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