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Implications of the Systolic Hypertension in China trial

L Liu1, J G Wang, H Celis

  • 1Hypertension Division, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing.

Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|July 28, 1999
PubMed

Insights

Antihypertensive treatment significantly reduces stroke and cardiovascular events in older Chinese adults with isolated systolic hypertension. This intervention offers substantial prevention of deaths, strokes, and major cardiovascular endpoints.

Area of Science:

  • Cardiology
  • Geriatrics
  • Public Health

Background:

  • Isolated systolic hypertension is a significant risk factor for cardiovascular complications in older populations.
  • The Systolic Hypertension in China (Syst-China) study aimed to address this prevalent condition.

Purpose of the Study:

  • To investigate the efficacy of active antihypertensive treatment in reducing stroke and cardiovascular complications.
  • To evaluate the impact of specific drug regimens on cardiovascular outcomes in elderly Chinese patients.

Main Methods:

  • A randomized controlled trial involving 1253 patients assigned active treatment (nitrendipine, captopril, hydrochlorothiazide) and 1141 controls receiving placebos.
  • Patients were stratified by center, sex, and prior cardiovascular complications.
  • Treatment involved nitrendipine with optional addition of captopril and/or hydrochlorothiazide.

Main Results:

  • Active treatment resulted in a significant reduction in systolic blood pressure by 9.1 mm Hg and diastolic by 3.2 mm Hg over 2 years.
  • Total stroke incidence decreased by 38%, all-cause mortality by 39%, and cardiovascular mortality by 39%.
  • Significant reductions were observed in stroke mortality (58%) and combined fatal/nonfatal cardiovascular endpoints (37%).

Conclusions:

  • Antihypertensive therapy is effective in preventing stroke and other cardiovascular complications in elderly Chinese patients with isolated systolic hypertension.
  • Long-term treatment could lead to substantial public health benefits, preventing numerous deaths and cardiovascular events.
  • The findings support the implementation of antihypertensive treatment strategies for this demographic.

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