valsartan in elderly isolated systolic hypertension (VALISH) study: rationale and design

Area of Science:

• Cardiology
• Geriatrics
• Pharmacology

Background:

• Antihypertensive therapy reduces cardiovascular risks, but optimal blood pressure targets in elderly hypertensive patients remain unclear.
• Isolated systolic hypertension is common in the elderly, necessitating specific treatment guidelines.

Purpose of the Study:

• To compare cardiovascular event incidence between two target systolic blood pressure levels (<140 mmHg vs. <150 mmHg) in elderly patients with isolated systolic hypertension.
• To evaluate the efficacy of valsartan, an angiotensin II receptor blocker, in achieving these targets.

Main Methods:

• The Valsartan in Elderly Isolated Systolic Hypertension (VALISH) study is a multicenter, parallel-group trial.
• Recruitment of 3,000 elderly patients with isolated systolic hypertension, with a follow-up duration of at least 2 years.
• Valsartan is used as the initial antihypertensive drug, with treatment guided by two target systolic blood pressure levels.

Main Results:

• The study is designed with 80% power to detect differences in cardiovascular event rates between the two target blood pressure groups.
• Estimated cardiovascular event rates are 21.5/1,000 patient-years for the <140 mmHg target and 29.1/1,000 patient-years for the <150 mmHg target.

Conclusions:

• The VALISH study will provide crucial data on age-specific blood pressure targets for treating isolated systolic hypertension in the elderly.
• Findings will inform clinical guidelines regarding the management of hypertension in older populations.