PROLOG Study: decreasing cardiovascular disease risk in hypertensive patients by antihypertensive therapy

Aim. To prove the benefits of long-term controlled antihypertensive therapy in patients with mild to moderate arterial hypertension (MiAH, MoAH), comparing to standard treatment in real-world clinical settings.
Material and methods. The study was a multi-center, randomized, comparative, prospective clinical trial in two parallel groups of MiAH and MoAH patients. The first group (intervention group, IG) received strictly regulated, step-wise AH treatment, including ACE inhibitor spirapril. The second group (control group, CG) continued standard antihypertensive treatment, administered earlier by the observing physician. The study lasted up to one year.
Results. In total, PROLOG study included 1742 patients: 854 in IG, and 888 in CG. The follow-up was completed for 1522 participants. There were 651 males (37.6%), and 1081 females (62.4%). Blood pressure (BP) substantially decreased in both groups, but during the whole follow-up period, the inter-group differences in systolic and diastolic BP (SBP, DBP) were statistically significant. Target BP levels (SBP <140 mm Hg, DBP <90 mm Hg) were registered more often in IG: 69.4% vs 39.3% in CG after 3 months, and 83.6% vs 66.9%, respectively, after 12 months. By the end of the study, cardiovascular risk reduction was observed in both groups, but was more prominent in IG: 33% vs 22%, respectively.
Conclusion. More effective SBP and DBP decrease, as well as BP target level achievement, due to controlled stepwise AH treatment in IG implicated greater improvement in life prognosis, comparing to CG. PROLOG results demonstrated cardiovascular risk reduction for both groups, but in IG it was greater by 50% than in CG.

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