Journal of Gerontological Nursing

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Treating Systolic Hypertension Can Prevent Strokes

Abstract

Drug treatment can help prevent strokes in older people with isolated systolic hypertension (ISH), according to a recent study. Isolated systolic hypertension is a common condition among older people.

The study, the Systolic Hypertension in the Elderly Program (SHEP), was funded by the National Institute on Aging and the National Heart, Lung, and Blood Institute. It was designed to test whether drug treatment to lower elevated systolic blood pressure can reduce the number of strokes, heart attacks, and deaths from cardiovascular disease in people age 60 and older. The study has significant impact for other people because the prevalence of elevated blood pressure increases with age.

According to the study, drug treatment with low doses of the diuretic chlorthalidone reduced the incidence of total stroke by 36%; coronary heart disease was reduced by 27%. The researchers write that this treatment is uncomplicated, inexpensive, and causes very few side effects. They note that when the diuretic alone is not sufficient to control the condition, a beta-adrenergic blocking drug, such as atenolol, may be added as long as there are no indications to the contrary.

In addition, treating ISH will likely result in fewer admissions to hospitals and nursing homes. SHEP participants who were treated had an 1 1 % lower rate of hospital and nursing home admissions than those who were not treated. Nationwide, treating ISH in older people could potentially prevent up to 73,000 hospital and nursing home admissions a year.

The randomized, double-blind, placebo-controlled study was conducted at 16 clinical centers across the country. Nearly 5,000 men and women participated in the 5-year study, beginning in 1984.

For more information, contact Carolyn Shanoff, National Institute on Aging Public Information Office, 301496-1 752.…

Drug treatment can help prevent strokes in older people with isolated systolic hypertension (ISH), according to a recent study. Isolated systolic hypertension is a common condition among older people.

The study, the Systolic Hypertension in the Elderly Program (SHEP), was funded by the National Institute on Aging and the National Heart, Lung, and Blood Institute. It was designed to test whether drug treatment to lower elevated systolic blood pressure can reduce the number of strokes, heart attacks, and deaths from cardiovascular disease in people age 60 and older. The study has significant impact for other people because the prevalence of elevated blood pressure increases with age.

According to the study, drug treatment with low doses of the diuretic chlorthalidone reduced the incidence of total stroke by 36%; coronary heart disease was reduced by 27%. The researchers write that this treatment is uncomplicated, inexpensive, and causes very few side effects. They note that when the diuretic alone is not sufficient to control the condition, a beta-adrenergic blocking drug, such as atenolol, may be added as long as there are no indications to the contrary.

In addition, treating ISH will likely result in fewer admissions to hospitals and nursing homes. SHEP participants who were treated had an 1 1 % lower rate of hospital and nursing home admissions than those who were not treated. Nationwide, treating ISH in older people could potentially prevent up to 73,000 hospital and nursing home admissions a year.

The randomized, double-blind, placebo-controlled study was conducted at 16 clinical centers across the country. Nearly 5,000 men and women participated in the 5-year study, beginning in 1984.

For more information, contact Carolyn Shanoff, National Institute on Aging Public Information Office, 301496-1 752.

10.3928/0098-9134-19910901-20

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