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Syst-Eur TRIAL |
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|---|---|
| Problem | Isolated systolic hypertension |
| Format | Double-blinded multi-center RCT |
| Treatment | Nitrendipine (+- enalapril +- hydrochlorothiazide) |
| Control | Placebo |
| Population | 4695 |
| Inclusion criteria | Aged > 60 BP > 160 / 95 |
| Exclusion criteria | Systolic hypertension secondary to a disorder needing specific medical or surgical treatment Retinal haemorrhage or papilloedema Congestive heart failure Dissecting aortic aneurysm Serum creatinine concentration at presentation of 180 mol/L or more History of severe nose bleeds, stroke, or myocardial infarction in the year before the study Dementia Substance abuse Any disorder prohibiting a sitting or standing position Any severe concomitant cardiovascular or non-cardiovascular disease. |
| Follow-up | Median 2 years |
| Primary endpoint | Fatal and nonfatal stroke |
| Secondary endpoint(s) | Death Stroke Retinal haemorrhage or exudates Myocardial infarction Congestive heart failure Dissecting aortic aneurysm Renal insufficiency. |
| Details | . |
| Brief summary: | Treatment initially with nitrendipine reduces stroke & CV events; ABPM better predictor of morbidity/mortality |
| PAPER: Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. | |
|---|---|
| Date | 13 Sep 1997 |
| Journal | Lancet. 1997 Sep 13;350(9080):757-64. |
| Information | For active treatment: -43.5% achieve target BP (21.4% for placebo) at median follow-up -Active treatment reduced all strokes by 42% -All fatal and nonfatal cardiac endpoints, including sudden death, decreased by 26% -The incidence of TIA was not significantly influenced |
| PAPER: Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. | |
|---|---|
| Date | 11 Aug 1999 |
| Journal | JAMA. 1999 Aug 11;282(6):539-46. |
| Information | Subgroup analysis comparing conventional and ambulatory BP measurement in elderly -Abulatory systolic BP was a significant predictor of cardiovascular risk over and above conventional BP |