Effects of immediate versus delayed antihypertensive therapy on outcome in the Systolic Hypertension in Europe Trial.

摘要: Background To assess the impact of immediate versus delayed anti hypertensive treatment on outcome older patients with isolated systolic hypertension, we extended double- blind placebo-controlled Systolic Hypertension in Europe (Syst- Eur) trial by an open-label follow-up study lasting 4 years. Methods The Syst-Eur included 4695 randomized minimum age 60 years and untreated blood pressure 160-219 mmHg below 95 diastolic. ended after a median 2.0 (range 1-97 months). Of 4409 still alive, 3517 received open- label consisting nitrendipine (10-40 mg daily) possible addition enalapril (5-20 daily), hydrochlorothiazide (12.5 - 25 or both add-on drugs. Non-participants (n = 892) were also followed up. Results Median increased to 6.1 decreased 150 (target level) 2628 participants (75.0%). During 4-year follow-up, stroke cardiovascular complications occurred at similar frequencies formerly placebo those continuing active treatment. These rates previously observed active-treatment group during double-blind trial. Considering total patients, compared reduced occurrence 28% (P=0.01) 15% (P=0.03), respectively, tendency for mortality (13%, P 0.09). In 492 diabetic corresponding estimates long-term benefit (P < 0.02) 60, 51 38%, respectively. Conclusions Antihypertensive can achieve control most hypertension. Immediate prevented 17 strokes major events per 1000 up 6 findings underscore necessity early J Hypertens 22:847 -857 (C) 2004 Lippincott Williams Wilkins.