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[Course of ischemic risk in treated atheromatous hypertensive patients. The PRIHAM study]
P Godeau1, F A Allaert, J Barrier
1Service de Médecine Interne, CH Pitié-Salpêtrière, Paris.
Insights
Urapidil effectively lowers blood pressure in high-risk patients with hypertension and atherosclerosis. This antihypertensive treatment demonstrated sustained cardiovascular risk reduction over three years with good tolerance.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension is a primary cardiovascular risk factor, often co-existing with other conditions.
- Assessing global cardiovascular status requires consideration of antihypertensive treatments.
Purpose of the Study:
- To evaluate the long-term effectiveness and safety of urapidil in hypertensive patients with a history of ischemic events.
Main Methods:
- The PRIHAM study was an open-label trial involving 3,216 hypertensive patients with atherosclerosis.
- Patients were followed for 3 years, with blood pressure and cardiovascular risk monitored.
Main Results:
- Urapidil significantly reduced systolic blood pressure by 14.4% and diastolic blood pressure by 15%.
- Blood pressure stabilization occurred within the first year and persisted without tachyphylaxis.
- No adverse metabolic effects were observed in diabetic or dyslipidemic patients, and tolerance was good.
Conclusions:
- Urapidil demonstrates effectiveness and good tolerance in high-risk cardiovascular patients.
- Its sustained blood pressure-lowering effect and safety profile make it suitable for managing complex hypertensive populations.
Abstract:
Hypertension is one of the major cardiovascular risk factors. However seldom occurs alone in a patient and the antihypertensive treatment should be taken into account when assessing global cardiovascular status. The PRIHAM study was an open study which enrolled 3,216 hypertensive atheromatous patients who already has had a clinical ischaemic accident. Patients were followed-up for 3 years. The lowering effect on cardiovascular risk, starting from the fifteenth month was confirmed to the end of 36-month study. The effect on blood pressure was observed from the third month. Stabilized blood pressure observed within the first year persisted throughout the three years without tachyphylaxis. It was effective on SBP (-14.4%) and on DBP (-15%) while maintaining a stable heart rate both in the supine position or immediately upon standing or after 3 minutes in the standing position. Amongst diabetic and dyslipidemic patients, an absence of deleterious metabolic effects was noticed, parallel with the effectiveness. Tolerance was globally judged as good or very good by the investigating practitioners and the patients expressed an improvement in their feeling of well-being. In conclusion, from the level of effectiveness obtained and the low incidence of adverse effects, urapidil appears well adapted and easy to manage in a population with a particularly high cardiovascular risk.