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Treating isolated systolic hypertension prevented major cardiovascular events across strata of risk in older patients

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 QUESTION: In older patients with isolated systolic hypertension (ISH), is blood pressure (BP) lowering treatment more effective than placebo for preventing major cardiovascular disease (CVD) events in those at high risk than in those at low risk?


Randomised {allocation concealed*}, blinded (outcome assessors),* placebo controlled trial with 4.5 years of follow up (subgroup analysis of the Systolic Hypertension in the Elderly Program [SHEP] trial).


{5 clinical centres in the US}.


4736 community dwelling patients who were ≥ 60 years of age and had ISH (systolic BP 160 to 219 mm Hg and diastolic BP < 90 mm Hg assessed and averaged over 2 visits), no atrial fibrillation, and no history of myocardial infarction (MI) or stroke in the previous 6 months. Patients taking antihypertensive medications were eligible if their …

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  • Sources of funding: National Heart, Lung, and Blood Institute and Claude D. Pepper Older Americans Independence Center.

  • For correspondence: Dr L Ferrucci, INRCA Geriatric Department, Florence, Italy. ferrucci{at}

  • * See glossary.

  • Information provided by author.