Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP)
Article Abstract:
Isolated systolic hypertension (ISH) is a systolic blood pressure reading of 160 millimeters of mercury (mm Hg) or more, but with a diastolic level in a normal range. This condition is common among older patients, and was previously thought to be a harmless, and perhaps even a beneficial, consequence of aging. More recently, it has been found that ISH increases the risk of stroke, other cardiovascular diseases, and death. The Systolic Hypertension in the Elderly Program (SHEP) compared 2,365 men and women receiving chlorthalidone, with or without atenolol, with 2,371 other patients who were given a placebo. All of the subjects had ISH with an baseline average of 170 mm Hg (systolic), and subjects were followed for a period of 60 months. The primary objective was to determine whether drug treatment to lower blood pressure would reduce strokes among these patients who were all 60 years or older. Other goals were to measure illness and death due to cardiovascular and all other causes, mental deterioration caused by strokes, depression, other indexes of quality of life. Drug therapy significantly reduced the risk of stroke among the group receiving antihypertensive medication (5.2 per 100 subjects) compared with the placebo group (8.2 per 100 subjects). Nonfatal heart attack and coronary death were also lower in the treatment group, as was the relative risk of death from all causes, although this difference was not statistically significant. It is concluded that antihypertensive drug treatment is effective in preventing stroke and other cardiovascular incidents among older patients with ISH. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
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Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension
Article Abstract:
Treatment of hypertension with low doses of the diuretic chlorthalidone may significantly reduce the risk of cardiovascular disease in diabetic and non-diabetic patients. This was demonstrated in the Systolic Hypertension in the Elderly Program (SHEP), in which 583 patients with type 2 diabetes and hypertension and 4,149 non-diabetic patients with hypertension were allocated to low doses of chlorthalidone or placebo. Chlorthalidone reduced the 5-year rate of major cardiovascular events such as heart attack and stroke by one-third in both diabetic and non-diabetic patients when compared to placebo.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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Effect of Treating Isolated Systolic Hypertension on the Risk of Developing Various Types and Subtypes of Stroke: The Systolic Hypertension in the Elderly Program (SHEP)
Article Abstract:
Treating hypertension in the elderly can reduce the risk of many different types of stroke. Researchers randomly assigned 4,736 elderly patients with hypertension to take antihypertensive drugs or a placebo for several years. Antihypertensive drugs reduced the risk of most types of stroke by 40% to 50%. In many cases, the results were seen within a year or two of beginning treatment.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2000
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