Published in , the Anglo-Scandinavian Cardiac Outcomes Trial – Blood Pressure Lowering Arm (ASCOT-BPLA) was conducted to. The latest data from ASCOT came from the blood pressure-lowering arm of the trial (ASCOT-BPLA). Following the presentation of preliminary. Cardiac Outcomes Trial: Blood Pressure-Lowering Arm – ASCOT-BPLA The ASCOT trial revealed the benefit of amlodipine/perindopril for.

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On the basis of previous trial evidence, these effects might not be entirely explained by better control of blood pressure, and this issue is addressed in the accompanying article. Our primary endpoint was non-fatal myocardial infarction including silent myocardial infarction and fatal CHD.

At the time, calcium channel blockers CCBs and ACE inhibitors ACEIs were novel antihypertensive agents hypothesized to have less adverse metabolic effects and provide additional cardiovascular protection beyond its blood pressure effects.

Nevertheless, the results have implications with respect to optimum combinations of antihypertensive agents. Our aim, therefore, was to compare the effect on non-fatal myocardial infarction and fatal CHD of combinations of atenolol with a thiazide versus amlodipine with perindopril. The apparent shortfall in prevention of coronary heart disease CHD noted in early hypertension trials has been attributed to disadvantages of the diuretics and beta blockers used.


Analysis was by intention to treat. However, the size of benefit was significantly less than predicted compared to previous observational studies [1].

For a given reduction in blood pressure, some suggested that newer agents would confer advantages over diuretics and beta blockers. This page was last modified on 15 Septemberat If goal BP cannot be reached with 2 drugs, add and titrate a third drug from the list provided.

However, the trial was underpowered as it was stopped early due to a significant reduction in all cause-mortality in the amlodipine and perindopril ascot-bppla. The incidence of developing diabetes was less on the amlodipine-based regimen vs ; 0.

Secondary outcomes suggest a possible reduction in cardiovascular morbidity and mortality using amlodipine and perindopril, although this may be ascribed to differences in blood pressure between the two study arms.

The main objective of hypertension treatment is to attain and maintain goal BP. The amlodipine-based arm had a significantly lower blood pressure than the atenolol-based arm throughout the entire study that may explain the differences in outcomes. Views Read View source View history.

ASCOT-BPLA – Wiki Journal Club

The trial was stopped prematurely due to a large difference in all-cause mortality between the two treatment groups. We did a multicentre, prospective, randomised controlled trial in 19 patients with hypertension who were aged troal and had at least three other cardiovascular risk factors.

The clinician should continue to assess BP and adjust the treatment regimen until goal BP is reached. It was hypothesized that adverse side effects of older antihypertensive agents, such as beta-blockers and diuretics, was partially offsetting the benefit of blood pressure reduction [1].



The amlodipine-based regimen prevented more major cardiovascular events and induced less diabetes than the atenolol-based regimen. Expert Opinion — Grade E. The study was stopped prematurely after 5. Intensive blood pressure lowering regimens had been shown in multiple randomized control trials to reduce cardiovascular axcot-bpla and mortality.

Among hypertensive patients at high risk of cardiovascular disease, ascpt-bpla a combination regimen of amlodipine and perindopril prevent more cardiovascular events than atenolol and bendroflumethiazide? Navigation menu Personal tools Create account Log in. The lack of statistical significance may have been due to early trial termination, as the trial did not meet the pre-specified number of primary events of Amlodipine and perindopril does not reduce cardiovascular morbidity and mortality xscot-bpla to atenolol and bendroflumethiazide.

Retrieved from ” http: Though not significant, compared with the atenolol-based regimen, fewer individuals on the amlodipine-based regimen had a primary endpoint vs ; unadjusted HR 0.

Republished in Curr Hypertens Rep.