Current Controlled Trials in Cardiovascular Medicine (Oct 2001)

How well can blood pressure be controlled? Progress report on the Systolic Hypertension in Europe Follow-Up Study (Syst-Eur 2)

  • Sarti Cinzia,
  • Nachev Choudomir,
  • Mantov Stefan,
  • Laks Tovio,
  • Leonetti Gastone,
  • Kermova Rumjana,
  • Fletcher Astrid E,
  • Celis Hilde,
  • Birkenhäger Willem H,
  • Bulpitt Christopher J,
  • Beleva Sonia,
  • Staessen Jan A,
  • Thijs Lutgarde,
  • Tuomilehto Jaakko,
  • Fagard Robert H

DOI
https://doi.org/10.1186/cvm-2-6-298
Journal volume & issue
Vol. 2, no. 6
pp. 298 – 306

Abstract

Read online

Abstract Background The randomised, double-blind, placebo-controlled Systolic Hypertension in Europe trial (Syst-Eur 1) proved that blood pressure (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 Syst-Eur 1. This paper presents the second progress report of this follow-up study (Syst-Eur 2). It describes BP control and adherence to study medications. Methods After the end of Syst-Eur 1 all patients, treated either actively or with placebo, were invited either to continue or to start antihypertensive treatment with the same drugs as previously used in the active treatment arm. In order to reach the target BP (sitting SBP Results Of the 3787 eligible patients, 3516 (93%) entered Syst-Eur 2. At the last available visit, 72% of the patients were taking nitrendipine. SBP/DBP at entry in Syst-Eur 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 randomised to placebo or active treatment had decreased by 16/5 mmHg and 7/5 mmHg, respectively. The target BP was reached by 74% of the patients. Conclusion Substantial reductions in systolic BP 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.

Keywords