Isolated systolic hypertension: lowering the risk of stroke in older patients. SHEP Cooperative Research Group

Abstract

The Systolic Hypertension in the Elderly Program (SHEP) was the first clinical trial to demonstrate the efficacy of low-dose antihypertensive medication in preventing stroke in older individuals with isolated systolic hypertension (ISH). The trial was multicentered, double-blind, randomized, placebo-controlled and involved 4,736 men and women, black and white, age 60 and over with ISH. Results showed a highly significant 36% reduction in nonfatal plus fatal stroke over 5 years in the group treated with active medication (low-dose chlorthalidone was step one), compared with the placebo group. Nonfatal plus fatal coronary disease and cardiovascular disease were also significantly reduced with antihypertensive medication, by 27% and 32% respectively, and total mortality was lower by 13%.