What question did this study set out to answer?

To compare the efficacy of conventional antihypertensives, calcium antagonists, and ACE inhibitors in reducing cardiovascular morbidity and mortality in elderly diabetic patients.

November 1, 2000Journal of Hypertension

Comparison of antihypertensive treatments in preventing cardiovascular events in elderly diabetic patients

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Why the study?

Do newer antihypertensive drugs (calcium antagonists or ACE inhibitors) reduce cardiovascular mortality compared to conventional drugs (diuretics or beta-blockers) in elderly diabetic patients?

Population

6,614 elderly hypertensive patients aged 70-84 years, including a subgroup of 719 patients with diabetes…

Comparison

Calcium antagonists or angiotensin converting… vs Conventional antihypertensive drugs

Design

RCT, randomly assigned, open trial with blinded endpoint evaluation

Authors

LLLars LindholmPreventive Cardiology LHLennart HanssonGeneral Cardiology TETord EkbomUniversité Claude Bernard Lyon 1

Discussion

Member takes

Implication

Supports conventional antihypertensives for cardiovascular mortality reduction in elderly diabetics; confirms equivalence to newer agents with ACE inhibitor benefit versus calcium antagonists for myocardial infarction.

Key Points

To compare the efficacy of conventional antihypertensives, calcium antagonists, and ACE inhibitors in reducing cardiovascular morbidity and mortality in elderly diabetic patients.
STOP Hypertension-2 was a prospective, randomized, open trial with blinded endpoint evaluation.
The study evaluated 719 elderly diabetic patients (mean age 75.8 years) from a wider cohort of 6,614 patients aged 70–84 years.
Participants were randomly assigned to conventional antihypertensives (diuretics or beta-blockers), calcium antagonists, or angiotensin converting enzyme (ACE) inhibitors.
Blood pressure reduction and cardiovascular mortality prevention were similar across all three treatment groups, with no significant differences in the primary endpoint.
ACE inhibitor treatment resulted in significantly fewer myocardial infarctions (n = 17) compared to calcium antagonist treatment (n = 32; RR 0.51, 95% CI 0.28–0.92, P = 0.025).
Strokes showed a non-significant trend toward higher occurrence in the ACE inhibitor group (n = 34) versus the calcium antagonist group (n = 29; RR 1.16, 95% CI 0.71–1.91).

Structured PICO

Do newer antihypertensive drugs (calcium antagonists or ACE inhibitors) reduce cardiovascular mortality compared to conventional drugs (diuretics or beta-blockers) in elderly diabetic patients?

Population

6,614 elderly hypertensive patients aged 70-84 years, including a subgroup of 719 patients with diabetes mellitus (mean age 75.8 years).

Intervention

Calcium antagonists or angiotensin converting enzyme (ACE) inhibitors

Comparator

Conventional antihypertensive drugs (diuretics or beta-blockers)

Outcome

Cardiovascular mortalityhard clinical

In elderly diabetic patients, conventional antihypertensives (diuretics/beta-blockers) are as effective as newer agents (ACE inhibitors/calcium antagonists) in preventing cardiovascular mortality, though ACE inhibitors may reduce myocardial infarction risk compared to calcium antagonists.

Cite This Study

Lindholm et al. (2000) studied this question.

synapsesocial.com/papers/6a71efab78a11c550e0bdd7d https://doi.org/10.1097/00004872-200018110-00020

Topics

Hypertension management

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Comparison of antihypertensive treatments in preventing cardiovascular events in elderly diabetic patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Comparison of antihypertensive treatments in preventing cardiovascular events in elderly diabetic patients

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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