Estimated Stroke-Free Survival of Folic Acid Therapy for Hypertensive Adults: Projection Based on the CSPPT

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#aged #blood-pressure #disease-free-survival #double-blind-method #female

Estimated Stroke-Free Survival of Folic Acid Therapy for Hypertensive Adults: Projection Based on the CSPPT

Zhang et al., 2020 | Hypertension | Rct

Citation

Zhang Tiantian, Lin Tengfei, ... Jiang Jie. Estimated Stroke-Free Survival of Folic Acid Therapy for Hypertensive Adults: Projection Based on the CSPPT. Hypertension. 2020-Feb;75(2):339-346. doi:10.1161/HYPERTENSIONAHA.119.14102

Abstract

The CSPPT (China Stroke Primary Prevention Trial) demonstrated a significant risk reduction of first stroke in hypertensive patients treated with enalapril plus folic acid compared with those with enalapril alone, but the lifetime stroke-free survival associated with the treatment is unknown. By establishing adjusted models for competing risks and an age-based time scale using data from 19 053 participants of the CSPPT, we estimated lifetime incremental stroke-free survival for enalapril-folic acid versus enalapril alone. Compared with enalapril alone, the enalapril plus folic acid treatment projected a mean lifetime stroke-free survival gain of 1.75 months, with an interquartile range from 0.73 to 2.39 months and the maximum gain up to 12.95 months. Subgroup analyses showed greater gain in stroke-free survival in younger, male patients, those with lower baseline folate levels, higher baseline systolic blood pressure, higher baseline total cholesterol and blood glucose, and with MTHFR (methylenetetrahydrofolate reductase) C677T CT or TT genotype. Overall, besides significant benefit in certain subgroups, enalapril plus folic acid treatment for hypertensive patients is associated with a modest gain in lifetime stroke-free survival, compared with enalapril alone.

Key Findings

Overall, besides significant benefit in certain subgroups, enalapril plus folic acid treatment for hypertensive patients is associated with a modest gain in lifetime stroke-free survival, compared with enalapril alone.

Outcomes Measured

  • blood pressure
  • systolic blood pressure

Population

Field Value
Population See abstract
Sample Size 053
Age Range See abstract
Condition blood pressure

MeSH Terms

  • Aged
  • Blood Pressure
  • Disease-Free Survival
  • Double-Blind Method
  • Female
  • Folic Acid
  • Follow-Up Studies
  • Humans
  • Hypertension
  • Male
  • Middle Aged
  • Primary Prevention
  • Stroke
  • Treatment Outcome
  • Vitamin B Complex

Evidence Classification

  • Level: Rct
  • Publication Types: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
  • Vertical: folate-cardiovascular

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09