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Randomized Controlled Trial
. 2013 Jun;15(6):420-7.
doi: 10.1111/jch.12094. Epub 2013 Apr 4.

Effects of intensive antihypertensive treatment on Chinese hypertensive patients older than 70 years

Yong Wei  1 , Zhimin Jin, Guoying Shen, Xiaowei Zhao, Wanhua Yang, Ye Zhong, Jiguang Wang
Affiliations
Randomized Controlled Trial

Effects of intensive antihypertensive treatment on Chinese hypertensive patients older than 70 years

Yong Wei et al. J Clin Hypertens (Greenwich). 2013 Jun.

Abstract

This study was performed to investigate whether intensive antihypertensive treatment with achieved blood pressure (BP) ≤140/90 mm Hg, as compared with standard treatment with achieved BP ≤150/90 mm Hg, could further improve cardiovascular outcomes in Chinese hypertensive patients older than 70 years. A total of 724 participants were randomly assigned to intensive or standard antihypertensive treatment. After a mean follow-up of 4 years, the mean achieved BP was 135.7/76.2 mm Hg in the intensive treatment group and 149.7/82.1 mm Hg in the standard treatment group. The visit-to-visit variability in systolic BP and diastolic BP was lower in the intensive group than that in the standard group. Intensive antihypertensive treatment, compared with the standard treatment, decreased total and cardiovascular mortality by 41.7% and 50.3%, respectively, and reduced fatal/nonfatal stroke by 42.0% and heart failure death by 62.7%. Cox regression analysis indicated that the mean systolic BP (P=.020; 95% confidence interval, 1.006-1.069) and the standard deviation of systolic BP (P=.033; 95% confidence interval, 1.006-1.151) were risk factors for cardiovascular endpoint events. Intensive antihypertensive treatment with achieved 136/76 mm Hg was beneficial for Chinese hypertensive patients older than 70 years. Long-term visit-to-visit variability in systolic BP was positively associated with the incidence of cardiovascular events.

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Figures

Figure 1
Figure 1
Protocols for the management of hypertension in the study. ACEI indicates angiotensin‐converting enzyme inhibitor; CCB, calcium channel blocker; BP, blood pressure.
Figure 2
Figure 2
Flow chart for the trial profile.
Figure 3
Figure 3
Mean systolic and diastolic blood pressure during follow‐up, in response to the intensive and standard antihypertensive treatment. SBP indicates systolic blood pressure; DBP, diastolic blood pressure.
Figure 4
Figure 4
Kaplan‐Meier estimates of cumulative rates of cardiovascular events (A) and stroke (B).
Figure 5
Figure 5
Kaplan‐Meier estimates of cumulative rates of all‐cause (A) and cardiovascular (B) death.
See this image and copyright information in PMC

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