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BACKGROUND@#Intensive systolic blood pressure (SBP) control improved outcomes in the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial. Whether baseline serum lipid parameters influence the benefits of intensive SBP control is unclear.@*METHODS@#The STEP trial was a randomized controlled trial that compared the effects of intensive (SBP target of 110 to <130 mmHg) and standard (SBP target of 130 to <150 mmHg) SBP control in Chinese patients aged 60 to 80 years with hypertension. The primary outcome was a composite of cardiovascular disease events. A total of 8283 participants from the STEP study were included in this post hoc analysis to examine whether the effects of the SBP intervention differed by baseline low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) concentrations.@*RESULTS@#Regardless of the randomized SBP intervention, baseline LDL-C and non-HDL-C concentrations had a J-shaped association with the hazard of the primary outcome. However, the effects of the intensive SBP intervention on the primary outcome were not influenced by baseline LDL-C level ( P for interaction = 0.80) and non-HDL-C level ( P for interaction = 0.95). Adjusted subgroup analysis using tertiles in LDL-C1 (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.52-1.13; P = 0.18), LDL-C2 (HR, 0.81; 95% CI, 0.55-1.20; P = 0.29), and LDL-C3 (HR, 0.68; 95% CI, 0.47-0.98; P = 0.04) was provided, with an interaction P value of 0.49. Similar results were showed in non-HDL-C1 (HR, 0.87; 95% CI, 0.59-1.29; P = 0.49), non-HDL-C2 (HR, 0.70; 95% CI, 0.48-1.04; P = 0.08), and non-HDL-C3 (HR, 0.67; 95% CI, 0.47-0.95; P = 0.03), with an interaction P -value of 0.47.@*CONCLUSION@#High baseline serum LDL-C and non-HDL-C concentrations were associated with increased risk of primary cardiovascular disease outcome, but there was no evidence that the benefit of the intensive SBP control differed by baseline LDL-C and non-HDL-C concentrations.@*CLINICAL TRIAL REGISTRATION@#ClinicalTrials.gov, NCT03015311.
Subject(s)
Aged , Humans , Cardiovascular Diseases , Blood Pressure/physiology , Cholesterol, LDL , Hypertension , Cholesterol , Risk FactorsABSTRACT
Objective To determine the plasma and intracellular concentration of Ara-C by the RPHPLC method and analyse the influence factors and the relationship between the concentration and drug dose.Methods Mononuclear cells and serum of 75 patients with acute leukemia were extracted after the first intravenous infusion of different administration dosage of Ara-C (0.5, 1.0, 2.0 g/m2), and analysed with different chromatographic conditions by RP-HPLC. Results The linear range of Ara-CTP was 0.28-18.96 μg/ml (r =0.998), and the detection limit was 0.28 μg/ml. The detection limit of Ara-C and Ara-U in plasma was 0.0157 μg/ml and 1.034 μg/mnl respectively. In 27 samples preserved for more than 1.5 years, 11 (40.7 %)cases of the plasma concentration of Ara-C were below the detection limit. In 36 samples of mononuclear cell count below 1.5×106/ml, 15 cases (41.7 %) of intracellular concentration of Ara-CTP were below the detection limit. The plasma concentration of Ara-U and intracellular concentration of Ara-CTP were increased with administration dosage of Ara-C increased, and the plasma concentration of Ara-C was not increased. The intracellular concentration of Ara-CTP in old patients over 40 years was tend to in crease with age.Conclusion The RP-HPLC method is simple, rapid, stable, reproducible and applicable for the monitoring of the plasma concentration of Ara-C and intracellular concentration of Ara-CTP. In 0.5-2.0 g/m2 dose range of Ara-C, the plasma concentration of Ara-U and intracellular concentration of Ara-CTP was increased with administration dosage of Ara-C increased.
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Objective To evaluate the effects of valsartan and angiotensin-converting enzyme inhibitors on the excretion rate of urinary albumm(UAER) and the clearance of endogenous creatinine(Cr-C) in elderly patients.Methods 120 elderly patients with stage of the 2～3 class hypertension were included.The patients were divided into 3 groups,the valsartan group and the benazpril group and captopril group,the anti-hypertensive effects and UAER and Cr-C were determined before and after the treatment.Results No significantly different anti-hypertensive effects were observed in valsartan,benazpril and captopril.But the effects of UAER,Cr-C in valsartan group had significant changes compared with the other groups,and the three groups had significant differentiation(P
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OBJECTIVE:To establish a simple and rapid ion-pair-RP-HPLC method for the determination of intracellular concentration of ara-CTP.METHODS:Mononuclearcells were separated from the whole blood,centrifugated and injected for determination on Symmetry C18 column with the mobile phase consisted of 0.1 mol?L-1 KDP buffer solution and 0.01 mol?L-1 tetrabutylammonium hydrogen sulfate(pH=2.7)at a flow rate of 1.0 mL?min-1 with the UV wavelength set at 278 nm.RESULTS:The linear range of ara-CTP was 0.35-9.12 ?g?mL-1(r=0.998 6)with its detection limit at 0.35 ?g?mL-1.The recoveries of ara-CTP at low,middle and high concentrations,and the intra-day and inter-day RSDs were all up to the standards.CONCLUSION:The established method is simple,rapid,stable,reproducible and applicable for the monitoring of intracellular concentration of ara-CTP.