Hindawi Publishing Corporation
International Journal of Hypertension
Volume 2013, Article ID 165789, 8 pages
http://dx.doi.org/10.1155/2013/165789
Clinical Study
Effect of Antihypertensive Therapy on SCORE-Estimated Total
Cardiovascular Risk: Results from an Open-Label, Multinational
Investigation—The POWER Survey
Guy De Backer,
1
Robert J. Petrella,
2
Assen R. Goudev,
3
Ghazi Ahmad Radaideh,
4
Andrzej Rynkiewicz,
5
and Atul Pathak
6
1
Department of Public Health, Ghent University Hospital, DePintelaan 185, 9000 Ghent, Belgium
2
Department of Family Medicine and Cardiology, Lawson Health Research Institute, 801 Commissioners Road East,
University of Western Ontario, ON, Canada, N6C 5J1
3
Preventive Cardiology Clinic, Department of Internal Medicine, Medical University of Sofa, Sofa 1431, Bulgaria
4
Rashid Hospital, P.O. Box 4545, Oud Metha Road, Dubai, UAE
5
Department of Cardiology, Medical University of Gda˜ nsk, M. Skłodowskiej-Curie 3a Street, 80-210 Gda˜ nsk, Poland
6
Clinical Pharmacology Service, INSERM Unit 1048, Faculty of Medicine, University Hospital Toulouse, 31073 Toulouse, France
Correspondence should be addressed to Guy De Backer; guy.debacker@ugent.be
Received 19 March 2013; Revised 21 May 2013; Accepted 4 June 2013
Academic Editor: Kazuomi Kario
Copyright © 2013 Guy De Backer et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. High blood pressure is a substantial risk factor for cardiovascular disease. Design & Methods. Te Physicians’
Observational Work on patient Education according to their vascular Risk (POWER) survey was an open-label investigation of
eprosartan-based therapy (EBT) for control of high blood pressure in primary care centers in 16 countries. A prespecifed element
of this research was appraisal of the impact of EBT on estimated 10-year risk of a fatal cardiovascular event as determined by the
Systematic Coronary Risk Evaluation (SCORE) model. Results. SCORE estimates of CVD risk were obtained at baseline from 12,718
patients in 15 countries (6504 men) and from 9577 patients at 6 months. During EBT mean (±SD) systolic/diastolic blood pressures
declined from 160.2 ± 13.7/94.1 ± 9.1 mmHg to 134.5 ± 11.2/81.4 ± 7.4mmHg. Tis was accompanied by a 38% reduction in mean
SCORE-estimated CVD risk and an improvement in SCORE risk classifcation of one category or more in 3506 patients (36.6%).
Conclusion. Experience in POWER afrms that (a) efective pharmacological control of blood pressure is feasible in the primary
care setting and is accompanied by a reduction in total CVD risk and (b) the SCORE instrument is efective in this setting for the
monitoring of total CVD risk.
1. Introduction
Elevated blood pressure is a powerful contributor to total
cardiovascular disease (CVD) risk. Clinical trials’ experience
supports the expectation of reduced cardiovascular risk
from blood pressure control [1]. However, blood pressure
control should not be applied in isolation. Rather, total
CVD risk should be estimated in order to adapt the nature
and intensity of preventive strategies to the circumstances
of individual patients. A range of risk prediction models
have been proposed for this purpose. One such is the
Systematic Coronary Risk Evaluation (SCORE) model [2].
Tis instrument, designed for use in primary prevention,
estimates the total risk of fatal CVD events over the next
10 years as a function of age, gender, systolic blood pressure
(SBP), total cholesterol, and smoking habits.
Eprosartan (Abbott Products Operations AG, Allschwil,
Switzerland) is an orally administered, nonpeptide, angiot-
ensin-receptor blocker widely approved within the European
Union and in the USA for the treatment of hypertension.
Te Physicians’ Observational Work on patient Education
according to their vascular Risk (POWER) study created