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How well can blood pressure be controlled? Progress report on the Systolic Hypertension in Europe Follow-Up Study (Syst-Eur 2).

Thijs L, Staessen JA, Beleva S, Birkenhäger WH, Bulpitt CJ, Celis H, Fletcher AE, Kermova R, Leonetti G, Laks T, Mantov S, Nachev C, Sarti C, Tuomilehto J, Fagard RH, On behalf of the Systolic Hypertension in Europe Investigato - Curr Control Trials Cardiovasc Med (2001)

Bottom Line: In order to reach the target BP (sitting SBP <150 mmHg), the first line agent, nitrendipine, could be associated with enalapril and/or hydrochlorothiazide.The target BP was reached by 74% of the patients.CONCLUSION: Substantial reductions in systolic BP may be achieved in older patients with isolated systolic hypertension with a treatment strategy starting with the dihydropyridine calcium-channel blocker, nitrendipine, with the possible addition of enalapril and/or hydrochlorothiazide.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hypertensie en Cardiovasculaire Revalidatie Eenheid, Katholieke Universiteit Leuven, Leuven, Belgium. Thijs@med.kuleuven.ac.be

ABSTRACT
BACKGROUND: The randomised, double-blind, placebo-controlled Systolic Hypertension in Europe trial (Syst-Eur 1) proved that blood pressure (BP) lowering therapy starting with nitrendipine reduces the risk of cardiovascular complications in elderly patients with isolated systolic hypertension. In an attempt to confirm the safety of long-term antihypertensive therapy based on a dihydropyridine, the Syst-Eur patients remained in open follow-up after the end of Syst-Eur 1. This paper presents the second progress report of this follow-up study (Syst-Eur 2). It describes BP control and adherence to study medications. METHODS: After the end of Syst-Eur 1 all patients, treated either actively or with placebo, were invited either to continue or to start antihypertensive treatment with the same drugs as previously used in the active treatment arm. In order to reach the target BP (sitting SBP <150 mmHg), the first line agent, nitrendipine, could be associated with enalapril and/or hydrochlorothiazide. RESULTS: Of the 3787 eligible patients, 3516 (93%) entered Syst-Eur 2. At the last available visit, 72% of the patients were taking nitrendipine. SBP/DBP at entry in Syst-Eur 2 averaged 160/83 mmHg in the former placebo group and 151/80 mmHg in the former active-treatment group. At the last follow-up visit SBP/DBP in the patients previously randomised to placebo or active treatment had decreased by 16/5 mmHg and 7/5 mmHg, respectively. The target BP was reached by 74% of the patients. CONCLUSION: Substantial reductions in systolic BP may be achieved in older patients with isolated systolic hypertension with a treatment strategy starting with the dihydropyridine calcium-channel blocker, nitrendipine, with the possible addition of enalapril and/or hydrochlorothiazide.

No MeSH data available.


Related in: MedlinePlus

Average sitting systolic and diastolic blood pressures at baseline and during follow-up in Syst-Eur 2. Open and closed symbols indicate the patients formerly randomised to placebo or active treatment, respectively. The total number of patients at each follow-up visit is presented separately for the 2 previous arms of the trial.
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Figure 2: Average sitting systolic and diastolic blood pressures at baseline and during follow-up in Syst-Eur 2. Open and closed symbols indicate the patients formerly randomised to placebo or active treatment, respectively. The total number of patients at each follow-up visit is presented separately for the 2 previous arms of the trial.

Mentions: At entry in Syst-Eur2, the mean sitting systolic BP in the patients formerly randomised to placebo was 160.4 ± 16.2 mmHg and in those of the former active-treatment group it was 151.0 ± 14.6 mmHg; the corresponding diastolic levels were 83.4 ± 7.7 mmHg and 79.6 ± 7.8 mmHg (Table 1). Of the 3516 patients, 1683 in the former placebo group and 1819 in the former active treatment group had their BP measured at least once during Syst-Eur2. At the last available visit in Syst-Eur2, in the patients of the former control group, the sitting blood pressure had fallen by 15.7 ± 18.7 mmHg systolic and by 5.1 ± 16.7 mmHg diastolic; in the patients previously randomised to active treatment, the corresponding BP reductions were 7.5 ± 16.7 mmHg systolic and 2.4 ± 11.8 mmHg diastolic, respectively (Fig. 2).


How well can blood pressure be controlled? Progress report on the Systolic Hypertension in Europe Follow-Up Study (Syst-Eur 2).

Thijs L, Staessen JA, Beleva S, Birkenhäger WH, Bulpitt CJ, Celis H, Fletcher AE, Kermova R, Leonetti G, Laks T, Mantov S, Nachev C, Sarti C, Tuomilehto J, Fagard RH, On behalf of the Systolic Hypertension in Europe Investigato - Curr Control Trials Cardiovasc Med (2001)

Average sitting systolic and diastolic blood pressures at baseline and during follow-up in Syst-Eur 2. Open and closed symbols indicate the patients formerly randomised to placebo or active treatment, respectively. The total number of patients at each follow-up visit is presented separately for the 2 previous arms of the trial.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC64833&req=5

Figure 2: Average sitting systolic and diastolic blood pressures at baseline and during follow-up in Syst-Eur 2. Open and closed symbols indicate the patients formerly randomised to placebo or active treatment, respectively. The total number of patients at each follow-up visit is presented separately for the 2 previous arms of the trial.
Mentions: At entry in Syst-Eur2, the mean sitting systolic BP in the patients formerly randomised to placebo was 160.4 ± 16.2 mmHg and in those of the former active-treatment group it was 151.0 ± 14.6 mmHg; the corresponding diastolic levels were 83.4 ± 7.7 mmHg and 79.6 ± 7.8 mmHg (Table 1). Of the 3516 patients, 1683 in the former placebo group and 1819 in the former active treatment group had their BP measured at least once during Syst-Eur2. At the last available visit in Syst-Eur2, in the patients of the former control group, the sitting blood pressure had fallen by 15.7 ± 18.7 mmHg systolic and by 5.1 ± 16.7 mmHg diastolic; in the patients previously randomised to active treatment, the corresponding BP reductions were 7.5 ± 16.7 mmHg systolic and 2.4 ± 11.8 mmHg diastolic, respectively (Fig. 2).

Bottom Line: In order to reach the target BP (sitting SBP <150 mmHg), the first line agent, nitrendipine, could be associated with enalapril and/or hydrochlorothiazide.The target BP was reached by 74% of the patients.CONCLUSION: Substantial reductions in systolic BP may be achieved in older patients with isolated systolic hypertension with a treatment strategy starting with the dihydropyridine calcium-channel blocker, nitrendipine, with the possible addition of enalapril and/or hydrochlorothiazide.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hypertensie en Cardiovasculaire Revalidatie Eenheid, Katholieke Universiteit Leuven, Leuven, Belgium. Thijs@med.kuleuven.ac.be

ABSTRACT
BACKGROUND: The randomised, double-blind, placebo-controlled Systolic Hypertension in Europe trial (Syst-Eur 1) proved that blood pressure (BP) lowering therapy starting with nitrendipine reduces the risk of cardiovascular complications in elderly patients with isolated systolic hypertension. In an attempt to confirm the safety of long-term antihypertensive therapy based on a dihydropyridine, the Syst-Eur patients remained in open follow-up after the end of Syst-Eur 1. This paper presents the second progress report of this follow-up study (Syst-Eur 2). It describes BP control and adherence to study medications. METHODS: After the end of Syst-Eur 1 all patients, treated either actively or with placebo, were invited either to continue or to start antihypertensive treatment with the same drugs as previously used in the active treatment arm. In order to reach the target BP (sitting SBP <150 mmHg), the first line agent, nitrendipine, could be associated with enalapril and/or hydrochlorothiazide. RESULTS: Of the 3787 eligible patients, 3516 (93%) entered Syst-Eur 2. At the last available visit, 72% of the patients were taking nitrendipine. SBP/DBP at entry in Syst-Eur 2 averaged 160/83 mmHg in the former placebo group and 151/80 mmHg in the former active-treatment group. At the last follow-up visit SBP/DBP in the patients previously randomised to placebo or active treatment had decreased by 16/5 mmHg and 7/5 mmHg, respectively. The target BP was reached by 74% of the patients. CONCLUSION: Substantial reductions in systolic BP may be achieved in older patients with isolated systolic hypertension with a treatment strategy starting with the dihydropyridine calcium-channel blocker, nitrendipine, with the possible addition of enalapril and/or hydrochlorothiazide.

No MeSH data available.


Related in: MedlinePlus