What question did this study set out to answer?

To evaluate the long-term efficacy, morbidity, and mortality over a 10-year period in patients with moderate to severe hypertension treated with an atenolol-based regimen.

August 1, 1987Journal of Hypertension

Low Mortality from All Causes, Including Myocardial Infarction, in Well-Controlled Hypertensives Treated with a Beta-Blocker Plus Other Antihypertensives

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Why the study?

Does atenolol-based antihypertensive therapy reduce mortality in patients with moderate to severe hypertension?

Population

939 patients with moderate to severe hypertension

Comparison

Atenolol administered either alone or with a… vs Predicted survival rates had the hypertension…

Design

Cohort

Follow-up

mean 6.1 years

Authors

JCJ. M. CruickshankAstraZeneca (United Kingdom)KPKjell PennertRoyal Marsden NHS Foundation Trust ARAnna E. S rman

Discussion

Member takes

Implication

Supports atenolol-based therapy benefit in moderate-severe hypertension; extends observational data but leaves open randomized confirmation.

Key Points

To evaluate the long-term efficacy, morbidity, and mortality over a 10-year period in patients with moderate to severe hypertension treated with an atenolol-based regimen.
Monitored 939 moderate to severe hypertensive patients treated in a single clinic with atenolol alone or combined with a diuretic and vasodilators over a mean follow-up of 6.1 years.
Compared intention-to-treat survival rates to predicted untreated mortality models and to an age- and sex-matched local reference population.
Treatment reduced mean blood pressure from 183/109 to 145/87 mmHg, with well-controlled on-treatment systolic blood pressure strongly predicting reduced mortality, particularly from myocardial infarction (P < 0.001).
Total mortality and myocardial infarction mortality were reduced to approximately 60% of predicted untreated levels, reaching rates similar to the matched reference population, while stroke mortality dropped to roughly 50% of predicted rates.
Possible J-curve dynamics indicated that reducing systolic pressure below 140–150 mmHg in elderly patients or diastolic pressure below 85 mmHg may not provide additional clinical benefit.

Structured PICO

Does atenolol-based antihypertensive therapy reduce mortality in patients with moderate to severe hypertension?

Population

939 patients with moderate to severe hypertension

Intervention

Atenolol administered either alone or with a diuretic with or without a vasodilator or other agents

Comparator

Predicted survival rates had the hypertension not been treated, and a local reference population matched for age and sex

Outcome

Total mortality, mortality due to myocardial infarction, and strokehard clinical

Atenolol-based antihypertensive therapy in moderate to severe hypertension reduces total and cardiovascular mortality to levels comparable to an age- and sex-matched reference population.

Cite This Study

Cruickshank et al. (1987) studied this question.

synapsesocial.com/papers/6a7fbd0337804d00d3785358 https://doi.org/10.1097/00004872-198708000-00016

Topics

Hypertension management

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Implication

Supports atenolol-based therapy benefit in moderate-severe hypertension; extends observational data but leaves open randomized confirmation.

Low Mortality from All Causes, Including Myocardial Infarction, in Well-Controlled Hypertensives Treated with a Beta-Blocker Plus Other Antihypertensives

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Low Mortality from All Causes, Including Myocardial Infarction, in Well-Controlled Hypertensives Treated with a Beta-Blocker Plus Other Antihypertensives

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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