• 中國醫(yī)學科學院阜外醫(yī)院（北京100037）;

背景與目的　 我國人群高血壓患病率呈上升趨勢，但血壓控制率很低。為優(yōu)化高血壓治療方案，提高血壓達標率，減少心腦血管事件，由劉力生教授任主席的中國高血壓綜合研究協(xié)作組特制定了以下中國高血壓綜合干預研究方案。
對象與方法　 符合以下4項者進入試驗：原發(fā)性高血壓，年齡50～79歲，至少伴有一項心血管病危險因素，知情同意。采用多中心隨機對照盲終點評估臨床試驗方法，12?000例患者被隨機分為初始小劑量氨氯地平+替米沙坦組或小劑量氨氯地平+利尿劑組；對其中血總膽固醇4.0～6.1 mmol/L者隨機分為小劑量他汀組或常規(guī)處理組；按社區(qū)隨機分為強化生活方式干預區(qū)或常規(guī)干預區(qū)。研究主要終點是非致命性卒中/心梗、心血管性死亡復合事件。定期隨訪，計劃隨訪4年。
預期結(jié)果　 累積主要終點事件500例，血壓控制率達到70％，優(yōu)化治療組降低心血管事件20％，明顯改善不良生活方式。全國150家協(xié)作醫(yī)院共同研究，預計2011年完成試驗。

引用本文： 王文,馬麗媛,張宇清,鄧卿,劉明波,劉力生,代表CHIEF研究協(xié)作組. 中國高血壓綜合干預研究方案——起始聯(lián)合降壓、適度調(diào)脂和生活方式綜合干預的全國多中心隨機對照試驗. 中國循證醫(yī)學雜志, 2007, 07(11): 810-815. doi: 復制

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  4. 4. Julius S, Kjeldsen SE, Weber M, et al; VALUE trial group. Outcomes in hypertensive patients at high cardiovascular risk treated with regimens based on valsartan or amlodipine: the VALUE randomised trial. Lancet, 2004, 363(9426): 2022-2031.
  5. 5. Weber MA, Bakris GL, Dahlöf B, et al. Baseline characteristics in the Avoiding Cardiovascular events through Combination therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial: a hypertensive population at high cardiovascular risk. Blood Press, 2007, 16(1): 13-19.
  6. 6. Sever PS, Dahlof B, Poulter NR, et al; ASCOT investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet, 2003, 361(9364): 1149-1158.
  7. 7. Messerli FH, Staessen JA. Amlodipine better than lisinopril? How one randomized clinical trial ended fallacies from observational studies. Hypertension, 2006, 48(3): 359-361.