Calcium Channel Blockade and Cardiovascular Prognosis in the European Trial on Isolated Systolic Hypertension
| Autor: | Peter W. de Leeuw, Robert Fagard, Aris D. Efstratopoulos, Astrid E. Fletcher, Guramy Arabidze, Blas Gil-Extremera, Lutgarde Thijs, M.L. Seux, Willem H. Birkenhäger, Kalina Kawecka-Jaszcz, Yair Yodfat, Matti Jääskivi, C Nachev, Jaakko Tuomilehto, Jan A. Staessen, Christopher J. Bulpitt, Roberto Fogari, Speranta Babeanu, John Webster, J C Petrie, Christopher Davidson |
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| Rok vydání: | 1998 |
| Předmět: |
Male
medicine.medical_specialty Randomization Systole Systolic hypertension medicine.drug_class Calcium channel blocker Placebo Hydrochlorothiazide Double-Blind Method Enalapril Nitrendipine Internal medicine Internal Medicine medicine Humans Aged Aged 80 and over business.industry Middle Aged Calcium Channel Blockers Prognosis medicine.disease Surgery Europe Blood pressure Cardiovascular Diseases Hypertension Cardiology Drug Therapy Combination Female business medicine.drug |
| Zdroj: | Hypertension. 32:410-416 |
| ISSN: | 1524-4563 0194-911X |
| DOI: | 10.1161/01.hyp.32.3.410 |
| Popis: | Abstract —In the double-blind Systolic Hypertension in Europe (Syst-Eur) Trial, active treatment was initiated with nitrendipine (10 to 40 mg/d) with the possible addition of enalapril (5 to 20 mg/d) and/or hydrochlorothiazide (12.5 to 25 mg/d) titrated or combined to reduce sitting systolic blood pressure by at least 20 mm Hg to P =0.05) fewer cardiovascular end points, and those progressing to other active treatments showed decreases ( P ≤0.01) in total mortality (40%), stroke (59%), and all cardiovascular end points (39%). Among the control patients, 863 used only the first-line placebo. Compared with this subgroup, patients receiving monotherapy with nitrendipine showed a nearly 50% ( P ≤0.004) reduction of all types of end points, including total and cardiovascular mortality. The full relative benefit from nitrendipine was seen as early as 6 months after randomization. To ascertain that the benefit conferred by the dihydropyridine was not due to selection bias, the 1327 patients remaining on monotherapy with nitrendipine were matched by gender, age, previous cardiovascular complications, and systolic blood pressure at entry with an equal number of placebo patients. In this analysis, nitrendipine reduced ( P ≤0.05) cardiovascular mortality by 41%, all cardiovascular end points by 33%, and fatal and nonfatal cardiac end points by 33%. Despite the limitations inherent in post hoc analyses, the present findings suggest that the calcium channel blocker nitrendipine, given as a single antihypertensive medication, prevents cardiovascular complications in older patients with isolated systolic hypertension. |
| Databáze: | OpenAIRE |
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