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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article discusses the results of the Kyoto HEART Study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00149227\u0026amp;atom=%2Fspmdc%2F9%2F4%2F11.atom\u0022\u003ENCT00149227\u003C\/a\u003E], designed to examine the effects of valsartan as an add-on to conventional therapy on morbidity and mortality in uncontrolled hypertensive patients with one or more cardiovascular risk factors.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHypertensive Disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EProfessor H. Matsubara, MD, Kyoto Prefectural University of Medicine, Kyoto, Japan, reported the results of the Kyoto HEART Study (\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00149227\u0026amp;atom=%2Fspmdc%2F9%2F4%2F11.atom\u0022\u003ENCT00149227\u003C\/a\u003E), designed to examine the effects of valsartan as an add-on to conventional therapy on morbidity and mortality in uncontrolled hypertensive patients with one or more cardiovascular (CV) risk factors. Valsartan (up to 160 mg\/daily) add-on treatment to improve blood pressure (BP) control prevented more CV events than conventional non-ARB treatment.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe KYOTO HEART study was a multicenter, prospective, randomized, open-label, blinded endpoint study in 3031 high-risk hypertensive (systolic BP \u2265140 and\/or diastolic BP \u226590 mmHg) Japanese patients (43% female, mean 66 years) with one or more CV risk factors (such as diabetes, smoking habit, lipid metabolism abnormality, a history of ischemic heart disease, cerebrovascular disease or peripheral arterial occlusive disease, obesity (BMI\u0026gt;25), and left ventricular hypertrophy on electrocardiogram). The primary endpoint was a composite of fatal and nonfatal cerebrovascular and CV events (new-onset or recurrence of stroke, new-onset or recurrence of acute myocardial infarction [MI] or angina pectoris, hospitalization due to heart failure, operation of percutaneous coronary intervention [PCI] or coronary artery bypass graft [CABG], new-onset or recurrence of peripheral arterial disease or aortic dissection, transition to dialysis, and doubling of plasma Cr levels).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn total, the study gathered information for 8864 patients (valsartan add-on group, 4448; non-ARB group, 4416), and median follow-up period was 3.27 years. After 48 months, the reduction in BP was the same in the two groups (from 157\/88 to 133\/76 mm Hg). Patients who were treated with valsartan add-on therapy experienced 45% fewer fatal and nonfatal CV events (5.4%) versus those who were on conventional therapy alone (10.2%) (HR, 0.55; 95% CI, 0.42 to 0.72; p=0.00001; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). There were significant (p\u0026lt;0.03) reductions in the incidences of angina pectoris, stroke, and new-onset diabetes. Adverse events were low in both groups.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/4\/11\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Primary Endpoint.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1889846178\u0022 data-figure-caption=\u0022Primary Endpoint.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/4\/11\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/4\/11\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/9\/4\/11\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11342\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EPrimary Endpoint.\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission by H. Matsubara.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-6\u0022\u003EValsartan add-on treatment to improve BP control prevented more CV events than conventional non-ARB treatment in high-risk hypertensive patients in Japan. These benefits can not be entirely explained by a difference in BP control. Prof. Matsubara believes \u201cthis study provides useful information for daily clinical practice in Asian and probably in Europe\/US patients.\u201d\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe Kyoto HEART study was discussed by Professor F. Ruschitzka, MD, University Hospital, Zurich, Switzerland, who pointed out that the achievement of the primary endpoint in this study was driven by reductions in angina and stroke, but no benefit was seen in the reduction of MI incidence, in which most cardiologists are interested. He cautioned that there is even some evidence (VALUE trial) that valsartan increases the risk of MIs [Julius S et al. \u003Cem\u003ELancet\u003C\/em\u003E 2004]. Prof. Ruschitzka concluded that ARBs are efficacious and even superior to other drug classes in stroke prevention, but their efficacy with regard to coronary events remains uncertain.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EFull article available at: \u003Ca href=\u0022http:\/\/eurheartj.oxfordjournals.org\/cgi\/content\/full\/ehp363\u0022\u003Ehttp:\/\/eurheartj.oxfordjournals.org\/cgi\/content\/full\/ehp363\u003C\/a\u003E.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2009 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/9\/4\/11.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmike\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmike\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}