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CAFE, an ASCOT substudy

CAFE, an ASCOT substudy. C onduit A rtery F unction E valuation A nglo- S candinavian C ardiac O utcomes T rial. CAFE, an ASCOT substudy: Objectives. Examine the impact of 2 different BP-lowering regimens on brachial and central aortic blood pressures and other hemodynamic parameters

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CAFE, an ASCOT substudy

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  1. CAFE, an ASCOT substudy Conduit Artery Function EvaluationAnglo-Scandinavian Cardiac Outcomes Trial

  2. CAFE, an ASCOT substudy: Objectives • Examine the impact of 2 different BP-lowering regimens on brachial and central aortic blood pressures and other hemodynamic parameters • Determine whether there is a relationship between measurements of central aortic BP and cardiovascular-related outcomes within the CAFE study cohort CAFE Investigators. Circulation. 2006;113:1213-25.

  3. CAFE: Design N = 2199 5 UK ASCOT centers n = 126Excluded: HR irregularity Poor waveforms N = 2073Evaluable for tonometry n = 1042Amlodipine ± perindopril* n = 1031Atenolol ± bendroflumethiazide† n = 1042 Intent-to-treatn = 1038 Complete information n = 1031 Intent-to-treatn = 1030 Complete information *Newer antihypertensive regimen †Older antihypertensive regimen CAFE Investigators. Circulation. 2006;113:1213-25.

  4. Radial artery waveforms measured via noninvasive applanation tonometry Augmentation index (AIx) defined as ratio of augmentation (∆ P) to central pulse pressure: Alx = (∆ P/PP) × 100 CAFE: Methods SP ∆ P P1 Pressure(mm Hg) DP Incisura ED Time (msec) SP = central aortic systolic pressure DP = central aortic diastolic pressure ED = ejection duration CAFE Investigators. Circulation. 2006;113:1213-25.

  5. CAFE: Lower central aortic BP with newer vs older antihypertensive regimen despite similar brachial BP 140 Brachial SBP 135 130 Central aortic SBP mm Hg 125 120 115 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 5.5 6 Time (years) Amlodipine ± perindoprilAtenolol ± bendroflumethiazide CAFE Investigators. Circulation. 2006;113:1213-25.

  6. CAFE: Lower augmentation index with newer antihypertensive regimen P < 0.0001 Atenolol ± bendroflumethiazide* Amlodipine ± perindopril† *Older antihypertensive regimen †Newer antihypertensive regimen CAFE Investigators. Circulation. 2006;113:1213-25.

  7. CAFE: Summary • Amlodipine ± perindopril showed substantial and consistent differences in central aortic BP and hemodynamics compared to atenolol ± bendroflumethiazide, despite similar brachial systolic BP changes • Differential effects on central aortic systolic BP and central aortic pulse pressure may explain the differences in clinical outcomes observed in ASCOT-BPLA • Central aortic pulse pressure may be a determinant of CV outcomes CAFE Investigators. Circulation. 2006;113:1213-25.

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