Br Med J (Clin Res Ed)  1986;293:1145-1151 (1 November), doi:10.1136/bmj.293.6555.1145

Randomised trial of treatment of hypertension in elderly patients in primary care.

J Coope, T S Warrender

A randomised trial of the treatment of hypertension in 884 patients aged 60 to 79 years at the onset showed a reduction of 18/11 mm Hg in blood pressure over a mean follow up period of 4.4 years. The principal antihypertensive agents were atenolol and bendrofluazide. There was a reduction in the rate of fatal stroke in the treatment group to 30% of that in the control group (95% confidence interval 11-84%, p less than 0.025). The rate of all strokes (fatal and non-fatal) in the treatment group was 58% of that in the control group (95% confidence interval 35-96%, p less than 0.03). The incidence of myocardial infarction and total mortality was unaffected by treatment. Questionnaires completed by the patients and their relatives failed to identify any differences in symptoms that were likely to be due to treatment.


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  • Bath, P. M.W., Geeganage, C., Gray, L. J., Collier, T., Pocock, S. (2008). Use of Ordinal Outcomes in Vascular Prevention Trials: Comparison With Binary Outcomes in Published Trials * Supplemental Appendix I: Statistical Tests Compared * Supplemental Appendix II: Supplementary Analyses * Supplemental Appendix III: Results. Stroke 39: 2817-2823 [Abstract] [Full text]  
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  • Authors/Task Force Members:, , Mancia, G., De Backer, G., Dominiczak, A., Cifkova, R., Fagard, R., Germano, G., Grassi, G., Heagerty, A. M., Kjeldsen, S. E., Laurent, S., Narkiewicz, K., Ruilope, L., Rynkiewicz, A., Schmieder, R. E., Struijker Boudier, H. A.J., Zanchetti, A., ESC Committee for Practice Guidelines (CPG):, , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Funck-Brentano, C., Hellemans, I., Kristensen, S. D., McGregor, K., Sechtem, U., Silber, S., Tendera, M., Widimsky, P., Zamorano, J. L., ESH Scientific Council:, , Kjeldsen, S. E., Erdine, S., Narkiewicz, K., Kiowski, W., Agabiti-Rosei, E., Ambrosioni, E., Cifkova, R., Dominiczak, A., Fagard, R., Heagerty, A. M., Laurent, S., Lindholm, L. H., Mancia, G., Manolis, A., Nilsson, P. M., Redon, J., Schmieder, R. E., Struijker-Boudier, H. A.J., Viigimaa, M., Document Reviewers:, , Filippatos, G., Adamopoulos, S., Agabiti-Rosei, E., Ambrosioni, E., Bertomeu, V., Clement, D., Erdine, S., Farsang, C., Gaita, D., Kiowski, W., Lip, G., Mallion, J.-M., Manolis, A. J., Nilsson, P. M., O'Brien, E., Ponikowski, P., Redon, J., Ruschitzka, F., Tamargo, J., van Zwieten, P., Viigimaa, M., Waeber, B., Williams, B., Zamorano, J. L. (2007). 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 0: ehm236v1-75 [Full text]  
  • van Melle, J. P., Verbeek, D. E.P., van den Berg, M. P., Ormel, J., van der Linde, M. R., de Jonge, P. (2006). Beta-Blockers and Depression After Myocardial Infarction: A Multicenter Prospective Study. J Am Coll Cardiol 48: 2209-2214 [Abstract] [Full text]  
  • Messerli, F. H., Mancia, G., Conti, C. R., Hewkin, A. C., Kupfer, S., Champion, A., Kolloch, R., Benetos, A., Pepine, C. J. (2006). Dogma Disputed: Can Aggressively Lowering Blood Pressure in Hypertensive Patients with Coronary Artery Disease Be Dangerous?. ANN INTERN MED 144: 884-893 [Abstract] [Full text]  
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  • Khan, N., McAlister, F. A. (2006). Re-examining the efficacy of {beta}-blockers for the treatment of hypertension: a meta-analysis. CMAJ 174: 1737-1742 [Abstract] [Full text]  
  • Lloyd-Jones, D. M., Evans, J. C., Levy, D. (2005). Hypertension in Adults Across the Age Spectrum: Current Outcomes and Control in the Community. JAMA 294: 466-472 [Abstract] [Full text]  
  • Wang, J.-G., Staessen, J. A., Franklin, S. S., Fagard, R., Gueyffier, F. (2005). Systolic and Diastolic Blood Pressure Lowering as Determinants of Cardiovascular Outcome. Hypertension 45: 907-913 [Abstract] [Full text]  
  • Messerli, F. H., Fournier, A. (2004). Re: Lawes et al: Blood Pressure and Stroke. Stroke 35: 2238-2238 [Full text]  
  • Messerli, F. H. (2004). Effects of Losartan in Hypertension without Vascular Disease. ANN INTERN MED 140: W-29-W-29 [Full text]  
  • Lawes, C. M.M., Bennett, D. A., Feigin, V. L., Rodgers, A. (2004). Blood Pressure and Stroke: An Overview of Published Reviews. Stroke 35: 1024-1033 [Abstract] [Full text]  
  • Lawes, C. M.M., Bennett, D. A., Feigin, V. L., Rodgers, A. (2004). Blood Pressure and Stroke: An Overview of Published Reviews. Stroke 35: 776-785 [Abstract] [Full text]  
  • Rashid, P., Leonardi-Bee, J., Bath, P. (2003). Blood Pressure Reduction and Secondary Prevention of Stroke and Other Vascular Events: A Systematic Review. Stroke 34: 2741-2748 [Abstract] [Full text]  
  • O'Sullivan, C., Duggan, J., Lyons, S., Thornton, J., Lee, M., O'Brien, E. (2003). Hypertensive Target-Organ Damage in the Very Elderly. Hypertension 42: 130-135 [Abstract] [Full text]  
  • Psaty, B. M., Lumley, T., Furberg, C. D., Schellenbaum, G., Pahor, M., Alderman, M. H., Weiss, N. S. (2003). Health Outcomes Associated With Various Antihypertensive Therapies Used as First-Line Agents: A Network Meta-analysis. JAMA 289: 2534-2544 [Abstract] [Full text]  
  • Staessen, J. A, Wang, J.-G., Birkenhager, W. H (2003). Outcome beyond blood pressure control?. Eur Heart J 24: 504-514 [Full text]  
  • Ko, D. T., Hebert, P. R., Coffey, C. S., Sedrakyan, A., Curtis, J. P., Krumholz, H. M. (2002). {beta}-Blocker Therapy and Symptoms of Depression, Fatigue, and Sexual Dysfunction. JAMA 288: 351-357 [Abstract] [Full text]  
  • Boutitie, F., Gueyffier, F., Pocock, S., Fagard, R., Boissel, J. P., for the INDANA Project Steering Committee, (2002). J-Shaped Relationship between Blood Pressure and Mortality in Hypertensive Patients: New Insights from a Meta-Analysis of Individual-Patient Data. ANN INTERN MED 136: 438-448 [Abstract] [Full text]  
  • Cruickshank, J.M (2000). Beta-blockers continue to surprise us. Eur Heart J 21: 354-364  
  • Messerli, F. H., Grossman, E., Goldbourt, U. (1998). Are {beta}-Blockers Efficacious as First-line Therapy for Hypertension in the Elderly?: A Systematic Review. JAMA 279: 1903-1907 [Abstract] [Full text]  
  • (1997). The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 157: 2413-2446 [Abstract]  
  • Pearce, K. A., Furberg, C. D., Rushing, J. (1995). Does Antihypertensive Treatment of the Elderly Prevent Cardiovascular Events or Prolong Life? A Meta-analysis of Hypertension Treatment Trials. Arch Fam Med 4: 943-949 [Abstract]  
  • Glynn, R. J., Brock, D. B., Harris, T., Havlik, R. J., Chrischilles, E. A., Ostfeld, A. M., Taylor, J. O., Hennekens, C. H. (1995). Use of Antihypertensive Drugs and Trends in Blood Pressure in the Elderly. Arch Intern Med 155: 1855-1860 [Abstract]  
  • Mulrow, C. D., Cornell, J. A., Herrera, C. R., Kadri, A., Farnett, L., Aguilar, C. (1994). Hypertension in the Elderly: Implications and Generalizability of Randomized Trials. JAMA 272: 1932-1938 [Abstract]  
  • Johannesson, M. (1994). The Impact of Age on the Cost - Effectiveness of Hypertension Treatment: An Analysis of Randomized Drug Trials. Med Decis Making 14: 236-244 [Abstract]  
  • Burris, J. F. (1993). {beta}-Blockers, Dyslipidemia, and Coronary Artery Disease: A Reassessment. Arch Intern Med 153: 2085-2092 [Abstract]  
  • (1993). The Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC V). Arch Intern Med 153: 154-183 [Abstract]  
  • Phillips, S. J., Whisnant, J. P. (1992). Hypertension and the Brain. Arch Intern Med 152: 938-945 [Abstract]  
  • SHEP Cooperative Research Group, (1991). Prevention of Stroke by Antihypertensive Drug Treatment in Older Persons With Isolated Systolic Hypertension: Final Results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 265: 3255-3264 [Abstract]  
  • Farnett, L., Mulrow, C. D., Linn, W. D., Lucey, C. R., Tuley, M. R. (1991). The J-Curve Phenomenon and the Treatment of Hypertension: Is There a Point Beyond Which Pressure Reduction Is Dangerous?. JAMA 265: 489-495 [Abstract]  
  • Olsson, G., Tuomilehto, J., Wikstrand, J. (1989). MAPHY and the Two Arms of HAPPHY-Reply. JAMA 262: 3272-3273 [Abstract]  
  • Applegate, W. B. (1989). Hypertension in Elderly Patients. ANN INTERN MED 110: 901-915 [Abstract]  



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