Long-term follow-up of moderately hypercholesterolemic hypertensive patients following randomization to pravastatin vs usual care: The antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT-LLT)
Margolis K.L.,Health Partners Institute for Education and Research |
Davis B.R.,University of Houston |
Baimbridge C.,University of Houston |
Ciocon J.O.,Cleveland Clinic |
And 15 more authors.
Journal of Clinical Hypertension | Year: 2013
The authors conducted a randomized, controlled, multicenter trial, in which they assigned well-controlled hypertensive participants aged 55 years and older with moderate hypercholesterolemia to receive pravastatin (n=5170) or usual care (n=5185) for 4 to 8 years, when trial therapy was discontinued. Passive surveillance using national databases to ascertain deaths and hospitalizations continued for a total follow-up of 8 to 13 years to assess whether mortality and morbidity differences persisted or new differences developed. During the post-trial period, fatal and nonfatal outcomes were available for 98% and 64% of participants, respectively. The primary outcome was all-cause mortality and the secondary outcomes included cardiovascular mortality, coronary heart disease (CHD), stroke, heart failure, cardiovascular disease, and end-stage renal disease. No significant differences appeared in mortality for pravastatin vs usual care (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.89-1.03) or other secondary outcomes. Similar to the previously reported in-trial result, there was a significant treatment effect for CHD in black patients (HR, 0.79; 95% CI, 0.64-0.98). However, the in-trial result showing a significant treatment by race effect did not remain significant during the entire follow-up (P=.08). These findings are consistent with evidence from other large trials that show statins prevent CHD and add evidence that they are effective for CHD prevention in black patients. © 2013 Wiley Periodicals, Inc.
G. Romanova L.,Veterans Affairs Medical Center Minneapolis |
A. Hansen E.,Veterans Affairs Medical Center Minneapolis |
Lam C.H.,Veterans Affairs Medical Center Minneapolis |
Lam C.H.,University of Minnesota
Microcirculation | Year: 2014
Isolation of rodent endothelial cells from lymphatic capillaries with yields that allow extensive functional studies remains challenging due to low cell numbers, variable purity, and limited growth potential. The purpose of this study was the generation and preliminary characterization of rat lymphatic cell line with extended replicative capacity. This cell line is intended for in vitro studies of cellular transport in lymphatic endothelium and for in vivo experiments in rat animal models. Methods: We created a novel rat lymphatic immortalized cell line, SV40-LEC, using retroviral gene transfer of SV40 large T antigen. We confirmed expression of characteristic markers and then examined its growth and transport properties. Results: SV40-LECs demonstrated improved proliferative capacity, but retained morphological characteristics of lymphatic cells and expression of established lymphatic markers. The cells form capillary-like network in vitro. SV40-LEC monolayer has similar permeability to that of the primary initial lymphatics. Paracellular transport in SV40-LECs is limited for substances >70 kDa. Barrier properties of the SV40-LECs can be modulated by cyclic adenosine monophosphate and histamine, which are known to affect microvascular permeability. Conclusion: The SV40-LECs provide an excellent tool for in vitro studies of properties of lymphatic endothelium, and may be suitable for in vivo transplantation studies. © 2014 John Wiley & Sons Ltd.