Stroke, Vol 20, 4-13, Copyright © 1989 by American Heart Association
HM Perry Jr, WM Smith, RH McDonald, D Black, JA Cutler, CD Furberg, MR Greenlick, LH Kuller, HW Schnaper and JA Schoenberger
The pilot study of the Systolic Hypertension in the Elderly Program was a
randomized, double-blind, placebo-controlled trial of drug therapy for
isolated systolic hypertension. It followed 551 elderly participants with
untreated blood pressures of greater than 160/less than 90 mm Hg for an
average of 34 months. Mean age of the participants was 72 years; 63% were
women, and 82% were white. Pretreatment blood pressures averaged 172/75 mm
Hg. Participants were randomly assigned to treatment with chlorthalidone or
placebo as Step I medication. Blood pressures at annual visits averaged
141/68 and 157/73 mm Hg for the drug-treated and placebo-treated groups,
respectively, with 60% and 33% of the survivors on blinded medication
having systolic blood pressures of less than 160 mm Hg at their last annual
visit. All-cause mortality rates for the drug-treated and placebo-treated
groups were 25.4 and 22.7 deaths per 1,000 participant-years of risk, and
rates for definite "first stroke" were 8.3 and 12.8 per 1,000 years of
risk. Differences between groups were significant for systolic and
diastolic blood pressure but not for death or stroke rates. A full-scale
study has begun to determine the effects of drug therapy for isolated
systolic hypertension on stroke and mortality rates.
ARTICLES
Morbidity and mortality in the Systolic Hypertension in the Elderly Program (SHEP) pilot study
Washington University School of Medicine, St. Louis, Missouri, MO.
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