VALUE Trial: Long-Term Blood Pressure Trends in 13,449 Patients With Hypertension and High

term Use Evaluation (VALUE) study compares cardiovascu-lar outcomes in 15,314 eligible patients from 31 countries randomized to valsartan or amlodipine-based treatment. Methods: The blood pressure (BP) trends are analyzed in 13,449 of VALUE study patients who had baseline BP and 24 months BP and treatment data. Results: In a cohort of 12,570 patients, baseline 24 and 30 months BP, but not 30 months treatment data, were available. Of 13,449 patients, 92 % (N 12,398) received antihyper-tensive therapy at baseline. The baseline BP was 153.5/86.9 mm Hg in treated compared to 168.1.8/95.3 mm Hg in 1051 untreated patients. After 6 months both groups had indistin-guishable BP values. At 12 months the BP decreased to 141.2/82.9 mm Hg (P .0001 for systolic BP and diastolic BP versus baseline), at 24 months to 139.1/80 mm Hg (P .0001 v 12 months), and to 138/79 mm Hg at 30 months (P .0001 v 24 months). The systolic BP control (140 mm Hg) at 30 months increased from 21.9 % at baseline to 62.2%, the diastolic BP ( 90 mm Hg) from 54.2 % to 90.2 % and the combined control (140 and 90 mm Hg) from 18.9 % to 60.5%. At 24 months 85.8 % of patients were on protocol drugs: monotherapy 39.7%, added hydrochlorothiazide 26.6%, add-on drugs 15.1%, and protocol drugs in non-standard doses 4.3%. Conclusions: The achieved BP control exceeds values reported in most published large-scale trials. The VALUE study is executed in regular clinical settings and 92 % of the patients received antihypertensive drugs at baseline. When an explicit BP goal is set, and a treatment algorithm is provided, the physicians can achieve better control rates than in their regular practice. Am J Hypertens 2003;16