Risk Factors for Stroke and Type of Stroke in Persons With Isolated Systolic Hypertension
Population
4736 persons aged >=60 years with isolated systolic hypertension
Comparison
Chlorthalidone with step-up to atenolol or… vs Matching placebo
Design
Cohort, randomized, double-blind, placebo-controlled
Follow-up
average 4.5 years
Authors
Discussion
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Implication
Supports subtype-specific risk stratification in systolic hypertension; leaves open whether targeting diabetes or smoking reduces lacunar events.
Structured PICO
P
Population
4736 persons aged >=60 years with isolated systolic hypertension (systolic blood pressure, 160 to 219 mm Hg; diastolic blood pressure, <90 mm Hg)
I
Intervention
Chlorthalidone (12.5 to 25 mg/d) with step-up to atenolol (25.0 to 50.0 mg/d) or reserpine (0.05 to 0.10 mg/d), if needed
C
Comparator
Matching placebo
O
Outcome
Stroke, stroke or transient ischemic attack (TIA), and stroke types: ischemic (including lacunar, atherosclerotic, and embolic) and hemorrhagichard clinical
In older patients with isolated systolic hypertension, diabetes and smoking are strong predictors of lacunar stroke, whereas carotid bruits predict atherosclerotic stroke.
Cite This Study
Davis et al. (1998) studied this question.