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- Title
P-433: How well can blood pressure be controlled? Progress report on the systolic hypertension in Europe follow-up study (Syst-Eur 2).
- Authors
Staessen, J. A.; Thijs, L.; Celis, H.; Fagard, R. H.
- Abstract
The Syst-Eur trial proved that 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 the double-blind Syst-Eur trial. This paper presents the second progress report of this follow-up study (Syst-Eur 2). It describes BP control and adherence to study medications. In order to reach the target BP (sitting SBP < 150 mmHg), the first line agent nitrendipine may be associated with enalapril, hydrochlorothiazide, both add-on study drugs, or if required any other antihypertensive drug. Of the 3787 eligible patients, 3516 (93%) entered phase 2 of the Syst-Eur trial. On 15 June 2000, 3021 were still being followed, 158 had died and 277 had proceeded to non-supervised open follow-up. Median follow-up in Syst-Eur phase 2 was 3 years. At the last available visit, 72% of the patients were taking nitrendipine, either in monotherapy (36%) or in combinations with other drugs. SBP/DBP at entry in Syst-Eur phase 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 randomized to placebo or active treatment had decreased by 16/5 and 7/5 mmHg, respectively. 74 % of the patients had reached the target BP and an additonal 14 % achieved a SBP between 150 and 159 mmHg. Substantial reductions in SBP 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. Phase 2 of the Syst-Eur trial will stop at the end of 2001 and will answer the question whether long-term treatment with nitrendipine provides better protection against cardiovascular events and dementia than short-term treatment without increasing the risk of adverse events.Am J Hypertens (2001) 14, 176A-176A; doi:S0895-7061(01)01605-3
- Publication
American Journal of Hypertension, 2001, Vol 14, p176A
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1016/S0895-7061(01)01605-3