March 1, 2005Blood Pressure
The Study on COgnition and Prognosis in the Elderly (SCOPE) – Major CV events and stroke in subgroups of patients
Key result
Candesartan-based therapy resulted in a non-significant 11% reduction in major cardiovascular events (p=0.19) and a 28% reduction in non-fatal stroke (p=0.04) compared to placebo.
Why the study?
Does candesartan reduce major cardiovascular events and stroke in subgroups of elderly patients with mild to moderate hypertension?
Population
4,937 elderly patients with mild to moderate hypertension.
Comparison
Candesartan 8-16 mg daily. vs Placebo.
Design
RCT, Randomized (method not specified)
Authors
Discussion
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Implication
Candesartan did not significantly reduce major cardiovascular events; extends evidence for non-fatal stroke reduction in elderly hypertensives.
Key Points
- The aim was to assess the impact of candesartan on cardiovascular outcomes in elderly patients with mild to moderate hypertension.
- Randomized trial involving 4937 elderly patients assigned to candesartan (n=2477) or placebo (n=2460).
- Evaluated blood pressure changes, with a modest reduction of 3/2 mmHg in the candesartan group.
- Analyzed results in pre-specified subgroups based on factors like age, gender, diabetes, and stroke history.
- Candesartan group showed a 28% reduction in non-fatal stroke (p=0.04).
- There was a non-significant 11% reduction in major cardiovascular events (p=0.19).
- Patients with a previous stroke experienced a 64% reduction in major cardiovascular events (p=0.004) compared to 5% in those without a history (p>0.20).
Study Design
Type
RCT (n=4,937)
Structured PICO
Does candesartan reduce major cardiovascular events and stroke in subgroups of elderly patients with mild to moderate hypertension?
P
Population
4,937 elderly patients with mild to moderate hypertension.
I
Intervention
Candesartan 8-16 mg daily.
C
Comparator
Placebo (both groups received extensive add-on therapy).
O
Outcome
Major cardiovascular events.hard clinical
Main Result
Effect estimate: 11% reduction
p-value: p=0.19
Candesartan-based therapy provides consistent cardiovascular benefits in elderly hypertensive patients, with a particularly pronounced reduction in major cardiovascular events among those with a prior stroke.
Limitations
- Due to extensive add-on therapy, blood pressure reduction was only about 3/2 mmHg greater in the candesartan group than in the control group.
Cite This Study
Trenkwalder et al. (2005) conducted an RCT in mild to moderate hypertension (n=4,937). candesartan vs. placebo was evaluated on major cardiovascular events (11% reduction, p=0.19). Candesartan-based therapy resulted in a non-significant 11% reduction in major cardiovascular events (p=0.19) and a 28% reduction in non-fatal stroke (p=0.04) compared to placebo.