August 11, 1999JAMA
Predicting Cardiovascular Risk Using Conventional vs Ambulatory Blood Pressure in Older Patients With Systolic Hypertension
Why the study?
Does ambulatory blood pressure monitoring better predict cardiovascular risk compared to conventional blood pressure measurement in older patients with isolated systolic hypertension?
Population
808 older patients with untreated isolated systolic hypertension
Comparison
Nitrendipine with possible addition of enalapril… vs Matching placebos
Design
RCT, Randomized to nitrendipine or to matching placebos, Double-blind…
Follow-up
October 1988 to February 1999
Authors
Discussion
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Member takes
Implication
Ambulatory BP monitoring improves cardiovascular risk stratification over clinic measurements in older isolated systolic hypertension; extends RCT evidence on its prognostic superiority.
Structured PICO
Does ambulatory blood pressure monitoring better predict cardiovascular risk compared to conventional blood pressure measurement in older patients with isolated systolic hypertension?
P
Population
808 older (aged ≥60 years) patients with untreated isolated systolic hypertension (conventional BP 160-219 mm Hg systolic and <95 mm Hg diastolic)
I
Intervention
Nitrendipine (10-40 mg/d) with possible addition of enalapril (5-20 mg/d) and/or hydrochlorothiazide (12.5-25.0 mg/d)
C
Comparator
Matching placebos
O
Outcome
Total and cardiovascular mortality, all cardiovascular end points, fatal and nonfatal stroke, and fatal and nonfatal cardiac end pointshard clinical
Ambulatory systolic blood pressure is a stronger predictor of cardiovascular risk than conventional blood pressure in older patients with isolated systolic hypertension.
Cite This Study
Jan A. Staessen (1999) studied this question.