Beneficial Effects of Valsartan in Asymptomatic Individuals With Vascular or Cardiac Abnormalities. The DETECTIV Pilot Study

Daniel Duprez, Natalia D. Florea, Kathryn Jones, Jay N Cohn

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Objectives: We studied the efficacy of valsartan (Val) to slow cardiovascular disease progression in asymptomatic high-risk prehypertensive or hypertensive patients with blood pressure (BP) controlled to <140/90 mm Hg and with evidence for functional or structural alterations in the cardiovascular system. Background: Identifying individuals with early markers for cardiovascular disease raises the possibility for pharmacotherapy to slow progression and delay or prevent future morbid events. Methods: Seventy-six subjects with a Rasmussen Disease Score (RDS) of 6 or higher were randomized double-blind to receive placebo (Plac) or Val 160 mg once daily for 6 months followed by 6 months of single-blind Val in both groups. A panel of 10 tests, including large and small artery elasticity, resting and treadmill exercise BP, carotid intimal-media thickness, retinal vascular photography, micro-albuminuria, electrocardiography, echocardiography, and plasma B-type natriuretic peptide, was performed at baseline and after 6 and 12 months of treatment. Each test result was scored as normal (0), borderline (1), or abnormal (2), and the total RDS was calculated by adding all the scores of the individual tests. Results: Valsartan significantly reduced the RDS after 6 months versus Plac (p < 0.03) and at 12 months (either 12 or 6 months of Val, p < 0.0001). The major contribution in risk score reduction was due to an increase in small artery elasticity and a decrease in BP, and after 12 months there was a reduction in left ventricular mass index (p < 0.03). Conclusions: Valsartan can slow progression and/or reverse early cardiovascular disease in asymptomatic high-risk patients with prehypertension or BP controlled to <140/90 mm Hg.

Original languageEnglish (US)
Pages (from-to)835-839
Number of pages5
JournalJournal of the American College of Cardiology
Volume50
Issue number9
DOIs
StatePublished - Aug 28 2007

Fingerprint

Valsartan
Blood Vessels
Blood Pressure
Cardiovascular Diseases
Elasticity
Arteries
Placebos
Prehypertension
Tunica Intima
Retinal Vessels
Albuminuria
Brain Natriuretic Peptide
Photography
Risk Reduction Behavior
Cardiovascular System
Echocardiography
Disease Progression
Electrocardiography
Exercise

Cite this

Beneficial Effects of Valsartan in Asymptomatic Individuals With Vascular or Cardiac Abnormalities. The DETECTIV Pilot Study. / Duprez, Daniel; Florea, Natalia D.; Jones, Kathryn; Cohn, Jay N.

In: Journal of the American College of Cardiology, Vol. 50, No. 9, 28.08.2007, p. 835-839.

Research output: Contribution to journalArticle

@article{3e0773c699be440ca5a890a459d8f56b,
title = "Beneficial Effects of Valsartan in Asymptomatic Individuals With Vascular or Cardiac Abnormalities. The DETECTIV Pilot Study",
abstract = "Objectives: We studied the efficacy of valsartan (Val) to slow cardiovascular disease progression in asymptomatic high-risk prehypertensive or hypertensive patients with blood pressure (BP) controlled to <140/90 mm Hg and with evidence for functional or structural alterations in the cardiovascular system. Background: Identifying individuals with early markers for cardiovascular disease raises the possibility for pharmacotherapy to slow progression and delay or prevent future morbid events. Methods: Seventy-six subjects with a Rasmussen Disease Score (RDS) of 6 or higher were randomized double-blind to receive placebo (Plac) or Val 160 mg once daily for 6 months followed by 6 months of single-blind Val in both groups. A panel of 10 tests, including large and small artery elasticity, resting and treadmill exercise BP, carotid intimal-media thickness, retinal vascular photography, micro-albuminuria, electrocardiography, echocardiography, and plasma B-type natriuretic peptide, was performed at baseline and after 6 and 12 months of treatment. Each test result was scored as normal (0), borderline (1), or abnormal (2), and the total RDS was calculated by adding all the scores of the individual tests. Results: Valsartan significantly reduced the RDS after 6 months versus Plac (p < 0.03) and at 12 months (either 12 or 6 months of Val, p < 0.0001). The major contribution in risk score reduction was due to an increase in small artery elasticity and a decrease in BP, and after 12 months there was a reduction in left ventricular mass index (p < 0.03). Conclusions: Valsartan can slow progression and/or reverse early cardiovascular disease in asymptomatic high-risk patients with prehypertension or BP controlled to <140/90 mm Hg.",
author = "Daniel Duprez and Florea, {Natalia D.} and Kathryn Jones and Cohn, {Jay N}",
year = "2007",
month = "8",
day = "28",
doi = "10.1016/j.jacc.2007.03.065",
language = "English (US)",
volume = "50",
pages = "835--839",
journal = "Journal of the American College of Cardiology.",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "9",

}

TY - JOUR

T1 - Beneficial Effects of Valsartan in Asymptomatic Individuals With Vascular or Cardiac Abnormalities. The DETECTIV Pilot Study

AU - Duprez, Daniel

AU - Florea, Natalia D.

AU - Jones, Kathryn

AU - Cohn, Jay N

PY - 2007/8/28

Y1 - 2007/8/28

N2 - Objectives: We studied the efficacy of valsartan (Val) to slow cardiovascular disease progression in asymptomatic high-risk prehypertensive or hypertensive patients with blood pressure (BP) controlled to <140/90 mm Hg and with evidence for functional or structural alterations in the cardiovascular system. Background: Identifying individuals with early markers for cardiovascular disease raises the possibility for pharmacotherapy to slow progression and delay or prevent future morbid events. Methods: Seventy-six subjects with a Rasmussen Disease Score (RDS) of 6 or higher were randomized double-blind to receive placebo (Plac) or Val 160 mg once daily for 6 months followed by 6 months of single-blind Val in both groups. A panel of 10 tests, including large and small artery elasticity, resting and treadmill exercise BP, carotid intimal-media thickness, retinal vascular photography, micro-albuminuria, electrocardiography, echocardiography, and plasma B-type natriuretic peptide, was performed at baseline and after 6 and 12 months of treatment. Each test result was scored as normal (0), borderline (1), or abnormal (2), and the total RDS was calculated by adding all the scores of the individual tests. Results: Valsartan significantly reduced the RDS after 6 months versus Plac (p < 0.03) and at 12 months (either 12 or 6 months of Val, p < 0.0001). The major contribution in risk score reduction was due to an increase in small artery elasticity and a decrease in BP, and after 12 months there was a reduction in left ventricular mass index (p < 0.03). Conclusions: Valsartan can slow progression and/or reverse early cardiovascular disease in asymptomatic high-risk patients with prehypertension or BP controlled to <140/90 mm Hg.

AB - Objectives: We studied the efficacy of valsartan (Val) to slow cardiovascular disease progression in asymptomatic high-risk prehypertensive or hypertensive patients with blood pressure (BP) controlled to <140/90 mm Hg and with evidence for functional or structural alterations in the cardiovascular system. Background: Identifying individuals with early markers for cardiovascular disease raises the possibility for pharmacotherapy to slow progression and delay or prevent future morbid events. Methods: Seventy-six subjects with a Rasmussen Disease Score (RDS) of 6 or higher were randomized double-blind to receive placebo (Plac) or Val 160 mg once daily for 6 months followed by 6 months of single-blind Val in both groups. A panel of 10 tests, including large and small artery elasticity, resting and treadmill exercise BP, carotid intimal-media thickness, retinal vascular photography, micro-albuminuria, electrocardiography, echocardiography, and plasma B-type natriuretic peptide, was performed at baseline and after 6 and 12 months of treatment. Each test result was scored as normal (0), borderline (1), or abnormal (2), and the total RDS was calculated by adding all the scores of the individual tests. Results: Valsartan significantly reduced the RDS after 6 months versus Plac (p < 0.03) and at 12 months (either 12 or 6 months of Val, p < 0.0001). The major contribution in risk score reduction was due to an increase in small artery elasticity and a decrease in BP, and after 12 months there was a reduction in left ventricular mass index (p < 0.03). Conclusions: Valsartan can slow progression and/or reverse early cardiovascular disease in asymptomatic high-risk patients with prehypertension or BP controlled to <140/90 mm Hg.

UR - http://www.scopus.com/inward/record.url?scp=34547927560&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34547927560&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2007.03.065

DO - 10.1016/j.jacc.2007.03.065

M3 - Article

VL - 50

SP - 835

EP - 839

JO - Journal of the American College of Cardiology.

JF - Journal of the American College of Cardiology.

SN - 0735-1097

IS - 9

ER -