预防中风的抗高血压药物治疗的老年人单纯收缩期高血压。老年人收缩期高血压项目的最终结果(谢普)。谢普合作研究小组。

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预防中风的抗高血压药物治疗的老年人单纯收缩期高血压。老年人收缩期高血压项目的最终结果(谢普)。谢普合作研究小组。

《美国医学协会杂志》上。1991年6月26日,265 (24):3255 - 64。

PubMed ID

2046107 (在PubMed

]

文摘

目的:评估抗高血压药物治疗的能力,减少非致命的和致命的风险(总)中风在单纯收缩期高血压。设计:多中心、随机、双盲、安慰剂对照。设置:以社区为基础的门诊人口在三级保健中心。参与者:4736人(1.06%)从447921年screenees 60岁及以上被随机分配(2371年2365年到积极治疗,安慰剂)。收缩压范围从160到219毫米汞柱,舒张压小于90毫米汞柱,参与者,3161没有接受抗高血压药物治疗的首次接触,和1575年。平均收缩压170毫米汞柱;平均舒张压,77毫米汞柱。平均年龄是72岁,57%是妇女,14%是黑人。干预措施:参与者分层临床中心和抗高血压药物在初始接触状态。步骤1的试验中,氯噻酮剂量1,12.5毫克/天,或匹配的安慰剂;剂量2 25 mg / d。 For step 2, dose 1 was atenolol, 25 mg/d, or matching placebo; dose 2 was 50 mg/d. MAIN OUTCOME MEASURES: Primary. Nonfatal and fatal (total) stroke. Secondary. Cardiovascular and coronary morbidity and mortality, all-cause mortality, and quality of life measures. RESULTS: Average follow-up was 4.5 years. The 5-year average systolic blood pressure was 155 mm Hg for the placebo group and 143 mm Hg for the active treatment group, and the 5-year average diastolic blood pressure was 72 and 68 mm Hg, respectively. The 5-year incidence of total stroke was 5.2 per 100 participants for active treatment and 8.2 per 100 for placebo. The relative risk by proportional hazards regression analysis was 0.64 (P = .0003). For the secondary end point of clinical nonfatal myocardial infarction plus coronary death, the relative risk was 0.73. Major cardiovascular events were reduced (relative risk, 0.68). For deaths from all causes, the relative risk was 0.87. CONCLUSION: In persons aged 60 years and over with isolated systolic hypertension, antihypertensive stepped-care drug treatment with low-dose chlorthalidone as step 1 medication reduced the incidence of total stroke by 36%, with 5-year absolute benefit of 30 events per 1000 participants. Major cardiovascular events were reduced, with 5-year absolute benefit of 55 events per 1000.

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