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SHEP TRIAL |
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| Problem | Isolated systolic hypertension, age > 60 |
| Format | Multicenter, randomized, double-blind, placebo-controlled trial |
| Treatment | Chlorthalidone +- Atenolol |
| Control | Placebo |
| Population | 4736 |
| Inclusion criteria | Patients aged 60 years and above with Systolic BP between 160 and 219 mm Hg and diastolic BP less than 90 mm Hg SHEP used primarily mass mailing and community screening techniques. |
| Exclusion criteria | Persons were excluded on the basis of history and/or signs of specified major cardiovascular diseases. Other major diseases, eg. cancer, alcoholic liver disease,established renal dysfunction, withcompeting risk for the SHEP primary end point or the presence of medicalmanagement problems, were alsoexclusions |
| Follow-up | 4.5 years average |
| Primary endpoint | Nonfatal and fatal (total) stroke |
| Secondary endpoint(s) | Cardiovascular and coronary morbidity and mortality, all-cause mortality, and quality of life measures |
| Details | . |
| Brief summary: | Chlorthalidone reduces stroke & CV events, may increase DM |
| PAPER: Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). | |
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| Date | 26 Jun 1991 |
| Journal | JAMA. 1991 Jun 26;265(24):3255-64. |
| Information | Low-dose chlorthalidone aged > 60: Reduced incidence of total stroke by 36% -5-year absolute benefit of 30 events per 1000 participants Major cardiovascular events were reduced -5-year absolute benefit of 55 events per 1000. |
| PAPER: Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes | |
|---|---|
| Date | 26 Jun 1991 |
| Journal | Am J Cardiol. 2005 Jan 1;95(1):29-35. |
| Information | Increased follow-up to 14.3 years -Increased development of diabetes but improved clinical outcomes -Improved especially among diabetics -Chlorthalidone-associated diabetes had no significant increase in CV events and had a better prognosis than had preexisting diabetics |