Effects of Angiotensin II Receptor Blocker Compared With Diuretics in High-risk Hypertensive Patients (CHIEF)

Effects of Angiotensin II Receptor Blocker Compared With Diuretics in High-risk Hypertensive Patients

Phase 4 Study of Effects of ARB Compared With Diuretics in Hypertension Patients With High Cardiovascular Risks

The aim of the study is to investigate the optimized treatment strategy of hypertension, so as to make more patients to reach the blood pressure goals and to reduce cardio-cerebrovascular events. Objective and Methods: Patients are eligible for inclusion in the study if they are essential hypertension, 50-79 years of age with at least one cardiovascular risk factor and sign the informed consent forms. This project is a multi-centre, prospective randomized,，openlabel blind-endpoint evaluation controlled (PROBE) trial. 12000 patients will be randomly assigned to either of low-dose Amlodipine+Telmisartan group or Amlodipine+ diuretics group. Among those patients with serum cholesterol between 4.0-6.1mmol/L, they will be also randomized into small dose of statin-based regimen or standard management regimen; Patients will also randomly assigned to intensive lifestyle intervention group or standard intervention group according to the community area where the patients in.

This study is aimed to observe the main outcome (stroke, myocardial infarction and death from cardiovascular disease) differences between different groups.

hypertension, cardiovascular risk factors, drugs intervention, lipid-lowering therapy, 50-79 years of age, sign, the informed, consent, forms

The primary study outcomes are composite of non-fatal stroke, non-fatal myocardial infarction and cardiovascular death.

All cardiovascular events；all-cause death, hospitalization for angina pectoris, coronary revascularization, aortic dissection, cerebrovascular disease, heart failure, renal insufficiency, tumor, new onset of atrial fibrillation and diabetes mellitus

Inclusion Criteria: essential hypertension 50-79 years old with at least one of the cardiovascular risk factor sign consent forms Exclusion Criteria: secondary hypertension attack of cerebrovascular events or myocardial infarction within recent 3 months coexistence of severe cardiomyopathy, rheumatic or congenital heart diseases unstable angina severe hepatopathy or nephropathy (ALT elevation > 2 fold or serum creatinine > 2.5mg/dl) malignant tumor gout women taking contraceptives or with pregnancy allergic history to the research drugs validated contradiction to the research drugs participating in other clinical trials unable for long-term follow-up or poor compliance unsuitable for clinical trial at the discretion of doctors in charge

Ma L, Wang W, Zhao Y, Zhang Y, Deng Q, Liu M, Sun H, Wang J, Liu L. Combination of amlodipine plus angiotensin receptor blocker or diuretics in high-risk hypertensive patients: a 96-week efficacy and safety study. Am J Cardiovasc Drugs. 2012 Apr 1;12(2):137-42. doi: 10.2165/11598110-000000000-00000.