April 1, 2004Journal of Hypertension
Effects of immediate versus delayed antihypertensive therapy on outcome in the Systolic Hypertension in Europe Trial
Why the study?
Does immediate compared with delayed antihypertensive treatment reduce stroke and cardiovascular complications in older patients with isolated systolic hypertension?
Population
4,695 older patients with isolated systolic hypertension.
Comparison
Immediate antihypertensive treatment. vs Delayed antihypertensive treatment.
Design
RCT, randomized, double-blind placebo-controlled followed by open-label
Follow-up
median 6.1 years
Authors
Discussion
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Member takes
Implication
Supports immediate antihypertensive initiation in older isolated systolic hypertension; confirms stroke and CV benefit of early versus delayed treatment.
Structured PICO
Does immediate compared with delayed antihypertensive treatment reduce stroke and cardiovascular complications in older patients with isolated systolic hypertension?
P
Population
4,695 older patients (minimum age 60 years) with isolated systolic hypertension (untreated blood pressure of 160-219 mmHg systolic and below 95 mmHg diastolic).
I
Intervention
Immediate antihypertensive treatment (active treatment during double-blind phase, followed by open-label nitrendipine 10-40 mg daily with possible addition of enalapril 5-20 mg daily, hydrochlorothiazide 12.5-25 mg daily, or both).
C
Comparator
Delayed antihypertensive treatment (placebo during double-blind phase, followed by the same open-label active treatment).
O
Outcome
Stroke and cardiovascular complications over a median follow-up of 6.1 years.hard clinical
Immediate initiation of antihypertensive therapy in older patients with isolated systolic hypertension significantly reduces long-term stroke and cardiovascular complications compared to delayed treatment.
Cite This Study
Staessen et al. (2004) studied this question.