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(Hypertension. 2001;38:1118.)
© 2001 American Heart Association, Inc.

Scientific Contributions

One-Year Study of Felodipine or Placebo for Stage 1 Isolated Systolic Hypertension

Henry R. Black; William J. Elliott; Michael A. Weber; William H. Frishman; Joel A. Strom; Philip R. Liebson; Clara T. Hwang; Dennis A. Ruff; Rafael Montoro; Vincent DeQuattro; Danyi Zhang; Margo M. Schleman; Michael I. Klibaner; for the Stage 1 Systolic Hypertension (SISH) Study Group

From the Department of Preventive Medicine, Rush Medical College of Rush University at Rush-Presbyterian-Saint Luke’s Medical Center (H.R.B., W.J.E., P.R.L.), Chicago, Ill; The Brookdale Hospital (M.A.W.), Brooklyn, NY; New York Medical College (W.H.F., J.A.S.), Valhalla; South Texas Clinical Trials (D.A.R.), San Antonio; Clinical Therapeutics Corp (R.M.), Coral Gables, Fla; University of Southern California (V.D.), Los Angeles; and AstraZeneca Pharmaceuticals, LP (C.T.H., D.Z., M.M.S., M.I.K.), Wayne, Pa.

Correspondence to: Henry R. Black, MD, Associate Vice President for Research, Rush-Presbyterian-St. Luke’s Medical Center, The Charles J. and Margaret Roberts Professor and Chair, Department of Preventive Medicine, Associate Dean for Research, Rush Medical College of Rush University, 1700 West Van Buren St, Suite 470, Chicago, IL 60612. E-mail hblack{at}rush.edu

Abstract—— A substantial number of older hypertensive patients have stage 1 isolated systolic hypertension (systolic blood pressure between 140 and 159 mm Hg and diastolic blood pressure <90 mm Hg), but there are currently no data showing that drug treatment is effective, safe, and/or beneficial. To compare the effects of active treatment compared with placebo on blood pressure, left ventricular hypertrophy, and quality of life among older stage 1 isolated systolic hypertensive patients, a randomized, double-blind, parallel-group, multicenter clinical trial comparing felodipine (2.5, 5, or 10 mg once daily) and matching placebo was performed in 171 patients (49% male, average age 66±7 years, with 49% white and 30% Hispanic) with a baseline blood pressure of 149±7/83±6 mm Hg. During 52 weeks of treatment, patients randomized to active treatment achieved significantly lower blood pressures (137.0±11.7/80.2±7.6 mm Hg for extended-release felodipine versus 147.5±16.0/83.5±9.7 mm Hg for placebo, P<0.01 for each), a reduced incidence of left ventricular hypertrophy (7% for extended release felodipine versus 24% for placebo, P<0.04), and improved quality of life (change in Psychological General Well-Being index, 3.0±6.8 for extended-release felodipine versus -0.8±10.3 for placebo, P<0.01) versus baseline. There were no clinically significant differences between treatments in tolerability or adverse effects. Stage 1 isolated systolic hypertension can be effectively and safely treated pharmacologically. Treatment reduced progression to the higher stages of hypertension, reduced the incidence of left ventricular hypertrophy, and improved an overall measure of the quality of life. Larger and longer studies will be needed to document any long-term reduction in cardiovascular event rates associated with treating stage 1 systolic hypertension.

Key Words: hypertrophy, left ventricular • quality of life • echocardiography • antihypertensive therapy • clinical trials

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				S. I. Chaudhry, H. M. Krumholz, and J. M. Foody Systolic Hypertension in Older Persons JAMA, September 1, 2004; 292(9): 1074 - 1080. [Abstract] [Full Text] [PDF]