See also:
		 
			
				
					All hypertension clinical trials
				
			
		
			
			All clinical trials of strategy 
			
		
		
			
			All clinical trials of more intensive blood pressure lowering strategie 
			
		
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	 | 
	
		
	
		
				
			Cardio-Sis study, 2009
				
		 | 
	 
	
	| 
			[NCT00421863]
	 | 
	 
 
	Treatments
	
	
		| Studied treatment | 
		
		tighter control of systolic BP with a goal of 
		
		One SBP measure higher than 130 mm Hg at any visit led to intensification of treatment. The choice of drugs in individual patients was left to the discretion of the investigators
		
		 | 
	 
	
		| Control treatment | 
		
		usual control, with a goal of 
		
		achievement of an SBP 
		 | 
	 
			| Treatments description  | 
				
				
						
						| Achieved systolic blood | 
						131.9 / 135.6 mmHg  | 
						 
						
						| Achieved diastolic blood pressure | 
						77.4 / 78.7 mmHg  | 
						 
				 	
				 | 
			 
	 
	
	
	
	Patients
	
		
			| Patients | 
			nondiabetic patients with hypertension and with SBP of 150 mm Hg or higher confirmed at two different times | 
		 
		
			| Inclusion criteria | 
			age >=55 years; SBP >150 mm Hg; antihypertensive treatment for at least 12 weeks; at least one of the following risk factors: smoking, family history of premature CAD, established CAD/PAD, previous TIA/stroke, total cholesterol >201 mg/dl, high-density lipoprotein cholesterol 135 mg/dl | 
		 
		
			| Exclusion criteria | 
			fasting glucose >126 mg/dl; reduced life expectancy; renal dysfunction (creatinine >2 mg/dl); clinically relevant hematologic or hepatic disorders; valvular heart disease; disorders associated with a confusion in the ECG diagnosis of LVH (complete right/left bundle branch block, Wolff-Parkinson-White syndrome, previous Q-wave MI, paced rhythm); AF; substance abuse
 | 
		 
				| Baseline characteristics | 
					
					
						
							| Age (mean), years | 
							67 y  | 
						 
						
							| female (%) | 
							59%  | 
						 
						
							| SBP | 
							163.3 mmHg  | 
						 
						
							| DBP | 
							89.75 mmHg  | 
						 
					 						
					 | 
				 
	 
	
	
	
	
	
	
	Method and design
	
	
		| Randomized effectives | 
		558 / 553 (studied vs. control) | 
	 
		
			| Design | 
			Parallel groups | 
		 
		
			| Blinding | 
			open | 
		 
		
			| Follow-up duration | 
			2 years | 
		 
		
			| Number of centre | 
			44 | 
		 
		
			| Geographic area | 
			Italy | 
		 
		
			| Hypothesis | 
			Superiority | 
		 
		
			| Primary endpoint | 
			ECG evidence of LVH  | 
		 
	
	 
	
	
	
	
	
	
	
  
	Results	
	
	
	
		
	
	
		
			Endpoint
		
	
	
		
		Studied treat. n/N
			
	
	
		
		Control treat. n/N
		
	
	
		
			Graph
		
	
	
		
			RR [95% CI]
		
	
	
		
			
				
				myocardial  infarction (fatal and non fatal) 
				 
			
		
			
				
				4 / 558 
				
			
			
				
				6 / 553 
				
			
		
			
				
					
						classic
					
					
					
				
			
				
				
			
			
		
			
				
					0,66 [0,19;2,33]
				
			
	
	
		
			
				
				Heart failure
				 
			
		
			
				
				3 / 558 
				
			
			
				
				7 / 553 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,42 [0,11;1,63]
				
			
	
	
		
			
				
				left ventricular hypertrophy
				 
			
		
			
				
				55 / 484 
				
			
			
				
				82 / 483 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,67 [0,49;0,92]
				
			
	
	
		
			
				
				All cause death
				 
			
		
			
				
				4 / 558 
				
			
			
				
				5 / 553 
				
			
		
			
				
					
						classic
					
					
					
				
			
				
				
			
			
		
			
				
					0,79 [0,21;2,94]
				
			
	
	
		
			
				
				stroke (fatal and non fatal) 
				 
			
		
			
				
				4 / 558 
				
			
			
				
				9 / 553 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,44 [0,14;1,42]
				
			
	
	
		
			
				
				Major cardiovascular events 
				 
			
		
			
				
				17 / 558 
				
			
			
				
				32 / 553 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,53 [0,30;0,94]
				
			
	
	
		
		
		
		
		
			
				0
			
		
		
		
		
		
				2
		
		
		
		
		
			1.0
		
	
  
 
	 
		
	
		
		
				
					| 
						Relative risks
					 | 
				 
			
			| Endpoint | 
			Events (%) | 
			Relative Risk | 
			95% CI | 
			Endpoint definition in the trial | 
			Ref | 
			 
			
			| Studied treat. | 
			Control treat. | 
			 
					
					
						| 
							myocardial  infarction (fatal and non fatal) 
						 | 
						4 / 558 (0,7%) | 
						6 / 553 (1,1%) | 
						0,66 | 
						[0,19;2,33] | 
						  | 
						  | 
					 
					
						| 
							stroke (fatal and non fatal) 
						 | 
						4 / 558 (0,7%) | 
						9 / 553 (1,6%) | 
						0,44 | 
						[0,14;1,42] | 
						strok eor TIA  | 
						  | 
					 
					
						| 
							Major cardiovascular events 
						 | 
						17 / 558 (3,0%) | 
						32 / 553 (5,8%) | 
						0,53 | 
						[0,30;0,94] | 
						death, MI, stroke, HF, angina, revascularization  | 
						  | 
					 
					
						| 
							left ventricular hypertrophy
						 | 
						55 / 484 (11,4%) | 
						82 / 483 (17,0%) | 
						0,67 | 
						[0,49;0,92] | 
						  | 
						  | 
					 
					
						| 
							All cause death
						 | 
						4 / 558 (0,7%) | 
						5 / 553 (0,9%) | 
						0,79 | 
						[0,21;2,94] | 
						  | 
						  | 
					 
					
					
					
						| 
							Heart failure
						 | 
						3 / 558 (0,5%) | 
						7 / 553 (1,3%) | 
						0,42 | 
						[0,11;1,63] | 
						admission for HF  | 
						  | 
					 
					
		
			| 
			The primary endpoint (if exists) appears in blod characters
			 | 
		 
		
			| 
			Reference(s) used for data extraction: 
			 | 
		 
		 
		
		
			
			| Endpoint | 
			studied treat. | 
			control treat. | 
			mean diff | 
			 
		 
	 
	
	
	
				
					| 
						Absolute risk reduction 
					 | 
				 
	
		| Endpoint | 
		Events rate | 
		Absolute risk reduction (ARR) | 
	 
	
		| Studied treat. | 
		Control treat. | 
	 
			
				| myocardial  infarction (fatal and non fatal)  | 
				7,17‰ | 
				1,08% | 
				
					-3,7‰
				 | 
			 
			
				| stroke (fatal and non fatal)  | 
				7,17‰ | 
				1,63% | 
				
					-9,1‰
				 | 
			 
			
				| Major cardiovascular events  | 
				3,05% | 
				5,79% | 
				
					-27,4‰
				 | 
			 
			
				| left ventricular hypertrophy | 
				11,36% | 
				16,98% | 
				
					-56,1‰
				 | 
			 
			
				| All cause death | 
				7,17‰ | 
				9,04‰ | 
				
					-1,9‰
				 | 
			 
			
				| Heart failure | 
				5,38‰ | 
				1,27% | 
				
					-7,3‰
				 | 
			 
	 	
	 
	
  
	
	
	
	
	
	
	
	
		 
		Reference(s)
	
	
	
			- 
				
			    Verdecchia P, Staessen JA, Angeli F, de Simone G, Achilli A, Ganau A, Mureddu G, Pede S, Maggioni AP, Lucci D, Reboldi G. 
			    Usual versus tight control of systolic blood pressure in non-diabetic patients with hypertension (Cardio-Sis): an open-label randomised trial..
			    Lancet 2009;374:525-33
 
				
					 
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