Protocol of the SPARTE Study: A Strategy for Preventing Cardiovascular and Renal Events based on ARTErial Stiffness
, Gilles Chatellier1, 2, 3, Michel Azizi1, 2, 4, 5, David Calvet6, 7, Gabriel Choukroun8, 9, Nicolas Danchin1, 2, 10, Pascal Delsart11, , Philippe Gosse12, , Gerard London13, Jean-Jacques Mourad14, Bruno Pannier13, Helena Pereira3, Dominique Stephan15, 16, Pierre Boutouyrie1, 2, 17, On Behalf of SPARTE Investigators†The list of all centers is given in Supplementary file.
- DOI
- 10.2991/artres.k.200711.001How to use a DOI?
- Keywords
- Antihypertensive drugs; arterial stiffness; cardiovascular events; clinical trial; hypertension
- Abstract
Whether arterial stiffness is a surrogate end-point for cardiovascular and renal disease has never been directly demonstrated by a controlled clinical trial. Our main hypothesis is a better prevention of outcomes in high risk hypertensives with PWV normalization driven strategy than with usual blood pressure driven therapeutic strategy based on European Society of Hypertension–European Society of Cardiology (ESH–ESC) guidelines. The strategy for preventing cardiovascular and renal events based on arterial stiffness study is a multicenter open-label randomized controlled trial with blinded endpoint evaluation comparing a therapeutic strategy targeting the normalisation of Pulse Wave Velocity (PWV group) versus a classical therapeutic strategy only implementing the ESH–ESC Guidelines (conventional group), for reducing cardiovascular and renal events. Patients with primary hypertension, aged 55–75 years, and at medium-to-very high cardiovascular risk will be included and followed-up for 4 years. In the PWV group, treatment will be adjusted to carotid-femoral PWV measured every 6 months. In the conventional group, PWV will be measured at baseline and every 2 years, but its value will be blinded to the investigator in charge of the patient. In the PWV group, the therapeutic strategy will preferably use a combination of Angiotensin-converting Enzyme Inhibitor (ACEI) [or Angiotensin Receptor Blockers (ARB)] and calcium channel blockers, as well as maximal recommended doses of ACEIs and ARBs. The primary combined endpoint includes stroke and coronary events (myocardial infarction, angioplasty, bypass), fatal or not, peripheral artery disease (angioplasty, bypass, amputation), hospitalization for heart failure, aortic dissection, chronic kidney disease (doubling of creatinine, dialysis), and sudden death. Twenty-five research centers will include a total of 1500 patients, in order to show a 20% reduction in the primary combined endpoint - the incidence of which is estimated at 10% per year - in the PWV group compared to the conventional group.
- Copyright
- © 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.
- Open Access
- This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
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TY - JOUR AU - Stephane Laurent AU - Gilles Chatellier AU - Michel Azizi AU - David Calvet AU - Gabriel Choukroun AU - Nicolas Danchin AU - Pascal Delsart AU - Philippe Gosse AU - Gerard London AU - Jean-Jacques Mourad AU - Bruno Pannier AU - Helena Pereira AU - Dominique Stephan AU - Pierre Boutouyrie AU - On Behalf of SPARTE Investigators PY - 2020 DA - 2020/07/17 TI - Protocol of the SPARTE Study: A Strategy for Preventing Cardiovascular and Renal Events based on ARTErial Stiffness JO - Artery Research SP - 250 EP - 260 VL - 26 IS - 4 SN - 1876-4401 UR - https://doi.org/10.2991/artres.k.200711.001 DO - 10.2991/artres.k.200711.001 ID - Laurent2020 ER -