gms | German Medical Science

28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

24. bis 27.11.2004, Hannover

Quantification of antihypertensive treatment effects on carotid atherosclerosis by 3-dimensional ultrasound: first report from the MORE-trial

Quantifizierung der antihypertensiven Behandlungseffekte auf die Karotis-Arteriosklerose durch dreidimensionalen Ultraschall: erster Bericht über die MORE-Studie

Meeting Abstract (Hypertonie 2004)

  • presenting/speaker K. Stumpe - Zentrum für Präventivmedizin (Bonn, D)
  • M. Ludwig - Interne Klinik Dr. Argirov (Berg, D)
  • E. Agabiti-Rosei - Universita di Brescia (Brescia, I)
  • J. Scholze - Campus Charité Mitte (Berlin, D)
  • P. Schwandt - Arteriosklerose-Präventions-Institut (München, D)
  • D. Schremmer - Gesellschaft für Therapieforschung mbH (München, D)
  • T. Zielinski - Klinik Niewubolnosci Serca (Warschau, PL)

Hypertonie 2004. 28. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Hannover, 24.-27.11.2004. Düsseldorf, Köln: German Medical Science; 2005. Doc04hochP121

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hoch2004/04hoch121.shtml

Veröffentlicht: 10. August 2005

© 2005 Stumpe et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: 3-dimensional (3-D) ultrasound (US) allows more accurate measurement of carotid artery (CA) plaque (PLQ) volume (V) than 2-D US. The Multicenter Olmesartan Atherosclerosis Regression Evaluation (MORE) trial is testing the hypothesis that for the same level of blood pressure (BP) control the AT1-receptor blocker olmesartan (O) is superior to the beta-blocker atenolol (A) in reversing or slowing progression of CA atherosclerosis by measuring PLQ volume (V) changes with a new 3-D US-technique.

Methods: Double-blind, randomized, in 5 European countries, 14 US centers, prospective 2-year comparison in hypertensives with high risk of CV events (i.e., one or more a priori defined risk factors) and at least one CA-plaque (volume > 4 <500 mm³). Patients are randomized to either O (20-40mg, o.d.) or A (50-100mg, o.d.). HCTZ (12.5-25mg) is added if required to achieve BP control. A newly developed US system (Voluson 530D-MT-3D CFM) providing both 3-D- and 2-D-imaging is used to measure V of CA-PLQ and CA-intima-media thickness (IMT). The end-points are changes in V CA-PLQ and CA-IMT at 2-year follow-up.

Results: Through February 04 a total of 441 patients had been screened and 176 had been randomized. At baseline CA-PLQ-V ranged from 10 to 350 mm³ and CA-IMT from 0.6 to 1.5 mm. There were no correlations between PLQ-V and IMT and PLQ-V and BP. Intra- and inter-observer 3-D US-measurement reliabilities were 95.2 % and 93 %, respectively, indicating high accuracy of the measurements.

Conclusion: The MORE is the first trial to demonstrate feasibility and reliability of a new non-invasive 3-D US-method for direct visualization of CA-PLQ and serial monitoring of PLQ-changes with treatment. The study has succesfully included a large number of high CV-risk hypertensives with CA-PLQ. 1-year treatment data from a blinded interim analysis of 135 patients will be available by November 04, and the results will be reported.