It is well known that blood pressure (BP) management reduces the incidence of cerebrovascular and cardiovascular events. However, it is unclear how many of these events occur in hypertensive patients who receive pharmacological treatment. The aim of this survey was to evaluate the occurrence rate of both types of events in patients receiving valsartan-based treatment. Of 30 366 patients treated with valsartan, 28 356 patients were observed for 2.93 years. Antihypertensive drugs other than valsartan were used in 56.8% of patients. After the administration of valsartan, the systolic and diastolic BP significantly decreased from 161.1±19.1/90.4±13.1 to 139.9±18.1/79.6±11.9 mm Hg. Cerebrovascular events were observed in 550 patients (1.94%, 9.29/1000 patient-years), and cardiac events were observed in 576 patients (2.03%, 9.73/1000 patient-years). A comparative analysis of the hazard ratios for cerebrovascular and cardiac events according to the BP level at the endpoint showed a BP-dependent reduction of risk for cerebrovascular events, and the change in risk exhibited a J-curve phenomenon in the relationship between cardiac events and systolic BP. The J-curve phenomenon was not observed in patients aged <75 years, but it was observed for the systolic BP in patients aged 75 years. Adverse drug reactions were observed in 1925 of 28 420 patients (6.77%). This post-marketing surveillance data for valsartan showed the outcomes for treated hypertensive patients in a large population in Japan who were followed for up to 3 years. These data will add important knowledge regarding the treatment of hypertension in Japan.

译文

众所周知,血压 (BP) 管理可降低脑血管和心血管事件的发生率。然而,目前尚不清楚这些事件中有多少发生在接受药物治疗的高血压患者中。这项调查的目的是评估接受缬沙坦治疗的患者两种类型的事件的发生率。在接受缬沙坦治疗的30例   366患者中,观察了28例   356患者2.93年。56.8% 患者使用缬沙坦以外的抗高血压药物。服用缬沙坦后,收缩压和舒张压从161.1 ± 19.1/90.4 ± 13.1降至139.9 ± 18.1/79.6 ± 11.9  mm Hg。在550例患者中观察到脑血管事件 (1.94%,9.29/1000患者年),在576例患者中观察到心脏事件 (2.03%,9.73/1000患者年)。根据终点的BP水平对脑血管事件和心脏事件的风险比进行比较分析,结果表明脑血管事件的风险降低了BP依赖性,并且风险的变化在心脏事件与收缩压之间的关系中表现出J曲线现象。在 <75岁的患者中未观察到J曲线现象,但在75岁的患者中观察到收缩压。观察28例420例 (6.77% 例) 药物不良反应1925年。缬沙坦的上市后监测数据显示了日本大量人群中接受治疗的高血压患者的结局,这些患者的随访时间长达3年。这些数据将增加有关日本高血压治疗的重要知识。

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