TABLE 3-1 Randomized Trials of the Treatment of Diastolic High Blood Pressure in the Elderly: Summary of Design and Outcome

Studya

Type

Age (yrs.)

Blood Pressure (mmHg)b

Medicationc

Outcome

VA

Randomized, double-blind, placebo-controlled

60–69

DBP 90–114

HCTZ/Reserpine

A 32% decrease in cardiovascular morbidity, did not reach significance. Magnitude of difference consistent with overall study.

HDFP

Randomized, special care vs. referred care

60–69

DBP 90–115

CTLD/Reserpine or alphamethyldopa

Statistically significant 16.4% reduction in total mortality for special care group.

Austr.

Randomized, double-blind, placebo-controlled

60–69

DBP 95–109

CTZ/various second step

A 39% reduction in trial endpoints for this treatment subgroup; did not reach statistical significance but reduction similar to overall study group.

EWPHE

Randomized, double-blind, placebo-controlled

60–97

DBP 90–119 SBP 160–239

HCTZ-triamterene/alpha-methyldopa

Significant 38% reduction in cardiac mortality; 32% reduction in cerebrovascular mortality did not quite reach significance.

Coope

Randomized, single-blind, no placebo for controls

60–79

DBP ≥ 05 SBP ≥ 1 70

Beta blocker/BNFZD

A 30% reduction in fatal strokes; no effect on myocardial infarction.

a VA = Veterans Administration Cooperative Study (see reference no. 73); HDFP = Hypertension Detection and Follow-up Program (see reference nos. 32 and 33); Austr = Australian Trial on Mild Hypertension (see reference no. 50); EWPHE = European Working Party on Hypertension in the Elderly (see reference nos. 2 and 3); Coope = Coope and Warrender study (see reference no. 16).

b DBP = diastolic blood pressure; SBP = systolic blood pressure.

c HCTZ = hydrochlorothiazide; CTZ = chlorothiazide; BNFZD = benfluorothiazide; CTLD = chlorthalidone.



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement