title: Antihypertensive therapy in older patients with isolated systolic hypertension: the Syst-Eur experience in general practice. The Syst-Eur Investigators.
abstract: OBJECTIVE
  This interim report from the Syst-Eur trial investigated the level of blood pressure control achieved during the double-blind period in patients followed in general practices.
  
  
  METHODS
  In the Syst-Eur trial elderly patients (60 years or older) with isolated systolic hypertension were randomized to either active or placebo treatment. Active treatment consisted of nitrendipine combined with enalapril and/or hydrochlorothiazide to reduce systolic pressure to < 150 mmHg and by > or = 20 mmHg. Matching placebos were used in the control group.
  
  
  RESULTS
  This analysis was restricted to patients of general practitioners who had been followed for at least 12 months. The placebo (N = 204) and active treatment (N = 217) groups had similar characteristics at randomization. At one year, the difference in sitting pressure between the two treatment groups was 10 mmHg systolic and 4 mmHg diastolic. Fewer patients remained on monotherapy in the placebo than in the active treatment group and on placebo the second and third line medications were started earlier. Nitrendipine tablets were discontinued in 10 patients on placebo and in 21 patients assigned to active treatment (P < 0.001 for all comparisons).
  
  
  CONCLUSIONS
  A significant blood pressure reduction can be achieved and maintained in older patients with isolated systolic hypertension followed by general practitioners. Whether this blood pressure reduction results in a clinically meaningful decrease of cardiovascular complications is under investigation.
authors.affiliation: Klinisch Laboratorium Hypertensie, Inwendige Geneeskunde-Cardiologie, Leuven, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Celis
authors.forename: Y
authors.initials: Y
authors.lastname: Yodfat
authors.forename: L
authors.initials: L
authors.lastname: Thijs
authors.forename: D
authors.initials: D
authors.lastname: Clement
authors.forename: J
authors.initials: J
authors.lastname: Cozic
authors.forename: P
authors.initials: P
authors.lastname: De Cort
authors.forename: F
authors.initials: F
authors.lastname: Forette
authors.forename: M
authors.initials: M
authors.lastname: Grégoire
authors.forename: J
authors.initials: J
authors.lastname: Heyrman
authors.forename: G
authors.initials: G
authors.lastname: Stibbe
authors.forename: M
authors.initials: M
authors.lastname: Van den Haute
authors.forename: J
authors.initials: J
authors.lastname: Staessen
authors.forename: R
authors.initials: R
authors.lastname: Fagard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001530:Belgium; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000627:therapeutic use*; D005194:Family Practice; D005260:Female; D005602:France; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D007557:Israel; D008297:Male; D008875:Middle Aged; D009568:Nitrendipine / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D006852:Hydrochlorothiazide; D004656:Enalapril; D009568:Nitrendipine