Morbidity and mortality after stroke in patients with diabetes - Subgroup analysis from the MOSES-Study

Journal of Clinical and Basic Cardiology

Kulschewski A¹  Lüders S¹  Diener HC¹  for the MOSES Study Group¹  Hammersen F¹  Berger J¹  Dominiak P¹  Plate K¹  Schrader J¹  Zidek W¹ 

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关键词: Diabetes mellitus;    Eprosartan;    Hypertonie;    Prävention;    Schlaganfall;    hypertension;    nitrendipine;    stroke prevention;   

DOI  :  

学科分类：心脏病和心血管学

来源: Krause & Pachernegg GmbH

【 摘 要 】

Background: The MOSES study was the first one to show significant advantages in the treatment with eprosartan in contrast to nitrendipine inthe secondary prevention of hypertensive stroke patients. In prespecified analyses, we compared the effects of antihypertensive treatment witheprosartan and nitrendipine on cerebro- and cardiovascular morbidity and mortality.Methods: As part of the MOSES study carried out in accordance with the PROBE design (prospective, randomised, open-label, blindedendpoint) we assigned a group of 498 hypertensive stroke patients with diabetes on eprosartan or nitrendipine based treatment with regard tocerebro- and cardiovascular events. Primary endpoint included all deaths and all recurrent cerebro- and cardiovascular events.Results: There were no relevant differences in the basic demographic data between eprosartan and nitrendipine based therapy. Initial similar bloodpressure values (150.7/85.2 mmHg versus 152.3/86.1 mmHg) turned into higher systolic and diastolic ones in the eprosartan group after 3 months and even reached statistical significance after 12 months (140.3/80.4 mmHg versus 135.9/78.5 mmHg) and 36 months (140.1/82.4 mmHg versus 134.9/78.8 mmHg). While primary endpoints, cerebro- and cardiovascular events showed no significant difference between eprosartan and nitrendipine based therapy groups, in contrast they were all significantly more frequent (p = 0.001) in the diabetic patients compared to the non-diabetic group.Conclusion: There was no difference in the event rate between both groups, although blood pressure reduction was significantly higher innitrendipine than eprosartan based therapy. This lacking difference is due to different blood pressure reduction. This underlies the outstandingimportance of blood pressure reduction in high-risk patients towards beyond blood pressure lowering effects of antihypertensive drugs.

【 授权许可】

Unknown