Related Experiment Videos
Calcium antagonists and atherosclerosis. The Multicenter Isradipine/Diuretic Atherosclerosis Study
C D Furberg1, N O Borhani, R P Byington
1Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1063.
Abstract:
The Multicenter Isradipine/Diuretic Atherosclerosis Study (MIDAS) is a double-blind, randomized, controlled clinical trial comparing the effects of isradipine and hydrochlorothiazide on the progression or regression of early carotid atherosclerosis in 883 hypertensive patients. Assessment of the outcome is by B-mode ultrasonographic measurement of early lesions (as reflected by intimal-medial wall thickening) at baseline and semiannually over 36 months. At baseline, the participants' mean age was 58.5 years. The study population was 78.6% male and 72.4% white. The average resting systolic and diastolic blood pressures were 149.8 and 96.5 mm Hg, respectively. Mean total serum cholesterol and low-density lipoprotein (LDL)-cholesterol levels were 216.2 mg/dL and 146.6 mg/dL, respectively. Risk factors for coronary artery disease were balanced at baseline between the two study groups. The mean maximum intimal-medial thickness at baseline (measured in the near and far walls of three segments for both carotid arteries) was 1.17 +/- 0.20 mm; the mean intimal-medial thickness of the single thickest lesion was 2.11 +/- 0.51 mm. Cross-sectional analyses show that intimal-medial thickness correlates independently with male gender, age, number of cigarettes smoked per day, levels of LDL cholesterol, systolic blood pressure, and white blood cell count. The MIDAS endpoint results will be available in 1993.
Insights
This clinical trial investigated if isradipine or hydrochlorothiazide could affect early carotid atherosclerosis progression in hypertensive patients. Results will reveal the impact of these common blood pressure medications on atherosclerosis.
Area of Science:
- Cardiology
- Vascular Biology
- Clinical Trials
Background:
- Hypertension is a major risk factor for atherosclerosis.
- Early detection and management of atherosclerosis are crucial for preventing cardiovascular events.
- The Multicenter Isradipine/Diuretic Atherosclerosis Study (MIDAS) addresses the need for comparative data on antihypertensive treatments' effects on atherosclerosis.
Purpose of the Study:
- To compare the effects of isradipine and hydrochlorothiazide on the progression or regression of early carotid atherosclerosis.
- To evaluate the impact of these medications on intimal-medial wall thickening in hypertensive patients.
Main Methods:
- A double-blind, randomized, controlled clinical trial involving 883 hypertensive patients.
- B-mode ultrasonography was used to measure carotid intimal-medial wall thickness at baseline and every six months for 36 months.
- Baseline characteristics, including age, gender, race, blood pressure, and lipid levels, were recorded.
Main Results:
- Baseline intimal-medial thickness averaged 1.17 +/- 0.20 mm, with the thickest lesion at 2.11 +/- 0.51 mm.
- Cross-sectional analysis indicated that intimal-medial thickness correlates with male gender, age, smoking, LDL cholesterol, systolic blood pressure, and white blood cell count.
- Risk factors for coronary artery disease were balanced between the isradipine and hydrochlorothiazide groups at baseline.
Conclusions:
- The study is designed to provide valuable insights into the differential effects of isradipine and hydrochlorothiazide on atherosclerosis.
- Findings will inform clinical practice regarding antihypertensive medication choices for patients with early atherosclerosis.