Efficacy of antihypertensive treatment for target organ protection in patients with masked hypertension (ANTI-MASK): a multicentre, double-blind, placebo-controlled trial

作者：Jian-Feng Huang, Dong‐Yan Zhang, De‐Wei An, Ming‐Xuan Li, Changyuan Liu, Yingqing Feng, Qidong Zheng, Xin Chen, Jan A. Staessen, Ji‐Guang Wang, Yan Li, Yan Li, Yan Li, Yan Li, Jian-Feng Huang, Dong-Yan Zhang, Yiqing Zhang, Ming-Xuan Li, Yi-Qing Zhang, Ji-Guang Wang, Xin Chen, Chang-Yuan Liu, Gui-Li Chang, Zhe Hu, Ying-Qing Feng, Xi-Da Li, Can Liu, Jiayi Huang, Yu-Ling Yu, Xuening Zhang, Yiyun Wang, Xue-Ning Zhang, Jing Yu, Ruixin Ma, Heng-Xia Liu, Xiaoping Chen, Qingtao Meng, Zhipeng Zhang, Yu Dou, Mei-Yu Zhu, Wen-Juan Wang, Li-Li Zhu, Min Zhang, Yinong Jiang, Yan Lu, Wei Yu, Xiao-Ling Xu, Qiu-Yan Dai, Yu-Feng Zhu, Jinshun Zhang, Yu Zhang, Jin-Shun Zhang, Jianjun Mu, Ling-Xin Liu, Jian-Jun Mu, Jing-Tao Xu, Yue-Yuan Liao, Hao Guo, Xinyue Liang, Jan A. Staessen · 发表于：EClinicalMedicine · 年份：2024 · DOI：10.1016/j.eclinm.2024.102736 · 被引用次数：11 · 研究领域：Blood Pressure and Hypertension Studies、Thermoregulation and physiological responses、Cardiovascular Health and Disease Prevention

Background: Masked hypertension is associated with target organ damage (TOD) and adverse health outcomes, but whether antihypertensive treatment improves TOD in patients with masked hypertension is unproven. Methods: In this multicentre, randomised, double-blind, placebo-controlled trial at 15 Chinese hospitals, untreated outpatients aged 30-70 years with an office blood pressure (BP) of <140/<90 mm Hg and 24-h, daytime or nighttime ambulatory BP of ≥130/≥80, ≥135/≥85, or ≥120/≥70 mm Hg were enrolled. Patients had ≥1 sign of TOD: electrocardiographic left ventricular hypertrophy (LVH), brachial-ankle pulse wave velocity (baPWV) ≥1400 cm/s, or urinary albumin-to-creatinine ratio (ACR) ≥3.5 mg/mmol in women and ≥2.5 mg/mmol in men. Exclusion criteria included secondary hypertension, diabetic nephropathy, serum creatinine ≥176.8 μmol/L, and cardiovascular disease within 6 months of screening. After stratification for centre, sex and the presence of nighttime hypertension, eligible patients were randomly assigned (1:1) to receive antihypertensive treatment or placebo. Patients and investigators were masked to group assignment. Active treatment consisted of allisartan starting at 80 mg/day, to be increased to 160 mg/day at month 2, and to be combined with amlodipine 2.5 mg/day at month 4, if the ambulatory BP remained uncontrolled. Matching placebos were used likewise in the control group. The primary endpoint was the improvement of TOD, defined as normalisation of baPWV, ACR or L...