Abstract | BACKGROUND: OBJECTIVES: To explore (1) whether the benefits of active treatment were evenly distributed across 4 strata, prospectively defined according to sex and previous cardiovascular complications, and (2) whether the morbidity and mortality results were influenced by age, level of systolic or diastolic blood pressure (BP), smoking or drinking habits, or diabetes mellitus at enrollment. METHODS: Eligible patients had to be 60 years or older with a sitting systolic BP of 160 to 219 mm Hg and diastolic BP less than 95 mm Hg. After stratification for center, sex, and previous cardiovascular complications, 1253 patients were assigned to active treatment starting with nitrendipine (10-40 mg/d), with the possible addition of captopril (12.5-50.0 mg/d), and/or hydrochlorothiazide (12.5-50 mg/d). In the 1141 control patients, matching placebos were used similarly. RESULTS: Male sex, previous cardiovascular complications, older age, higher systolic BP or lower diastolic BP, living in northern China, smoking, and diabetes mellitus significantly and independently increased the risk of 1 or more of the following end points: total or cardiovascular mortality, all fatal and nonfatal cardiovascular end points, all strokes, and all cardiac end points. In the placebo-control group diabetes raised the risk of all end points 2- to 3-fold (P< or =.05). However, active treatment reduced the excess risk associated with diabetes to a nonsignificant level (P values ranging from .12-.86) except for cardiovascular mortality (P = .04). Cox regression with adjustments applied for significant covariates suggested that active treatment may reduce total mortality more (P = .06) in women and stroke more (P = .07) in men and that it may provide better protection against cardiac end points in nonsmokers than smokers (P = .04). Otherwise, the benefits of active treatment were equally manifest, regardless of the enrollment characteristics of the patients, and regardless of whether active treatment consisted of only nitrendipine or of nitrendipine associated with other active drugs. CONCLUSIONS:
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Authors | J G Wang, J A Staessen, L Gong, L Liu |
Journal | Archives of internal medicine
(Arch Intern Med)
Vol. 160
Issue 2
Pg. 211-20
(Jan 24 2000)
ISSN: 0003-9926 [Print] United States |
PMID | 10647760
(Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antihypertensive Agents
- Hydrochlorothiazide
- Nitrendipine
- Captopril
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Topics |
- Aged
- Alcohol Drinking
(epidemiology)
- Antihypertensive Agents
(therapeutic use)
- Asian People
- Blood Pressure
- Captopril
(therapeutic use)
- Cardiovascular Diseases
(mortality, prevention & control)
- China
(epidemiology)
- Diabetes Complications
- Female
- Humans
- Hydrochlorothiazide
(therapeutic use)
- Hypertension
(drug therapy, mortality)
- Incidence
- Male
- Middle Aged
- Nitrendipine
(therapeutic use)
- Prospective Studies
- Risk Factors
- Sex Factors
- Smoking
(epidemiology)
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