CORD - COMPARISON OF RECOMMENDED DOSES

The CORD study is a multicentric, single blinded study testing the antihypertensive and metabolic efficacy of recommended doses of ramipril and losartan in hypertensive patients.
Patients treated > 3 moths with an ACE-I (treatment stopped 1 day before randomization) and with BP < 160/90 mmHg (group A) are switched to losartan 50mg. Patients not treated with an ACE-I or AIIA and with BP > 140/90 mmHg (group B) are randomized on treatment with losartan 50mg or ramipril 5mg. 
If blood pressure within one month does not decrease below 140/90mmHg titration to 100mg losartan resp. 10mg ramipril, the next step is adding of hydrochlorothiazid (month 3).
The inclusion of patients is „competitive, “till the number of patients treated with losartan reaches 9193 (LIFE population).
BP, heart rate, metabolic parameters (lipids, insulin resistance), renal functions, blood count and left ventricle hypertrophy are measured. The duration of the study is 12 months; SCORE risk is calculated at each visit.
The primary aim (group A) is to confirm the safety of switching from ACE-I to losartan and to confirm that losartan and ramipril in recommended doses (group B) have similar antihypertensive and metabolic effect, but the treatment with losartan is accompanied with less adverse events. 
The study was started in June 2006, 11 093 patients were included till the end of the year 2007. Mean age  is 61, 5 years, 5248 (47,7%) are male, 5739 (52,2%) are female, 16 (0,1%) sex not mentioned. The most frequent accompanying antihypertensive treatment are diuretics 44,6% and beta blockers 43,4%. 40,1% patients are treated with statins, ischemic heart disease is known in 30,9% and diabetes mellitus in 32,1% patients.
The study recruitment should be stopped in February 2007.
The study is supported by research grant of Czech Ministry of Health and Education VVZ MŠMT 0021 622 402