Shanghai trial of nifedipine in the elderly (STONE).
OBJECTIVE
To assess the effectiveness of nifedipine treatment in elderly hypertensives.


METHODS
A single-blind trial was conducted under the direction of the Shanghai Institute of Hypertension in 1632 subjects aged 60-79 years alternatively allocated to either nifedipine or placebo after a 4-week placebo run-in period between 1987 and 1990 with mean follow-up of 30 months. Clinical events and risk modification were analysed in collaboration with the University of Montreal. Seventy-four patients with severe hypertension were reallocated to active nifedipine treatment after placebo run-in.


RESULTS
Cox's proportional hazards model accounting for covariates demonstrated a highly significant decrease in the probability of events: 'original treatment assignment' analysis indicated that 77 events occurred in the placebo and 32 in the nifedipine group. Similar significances were achieved with 'actual treatment' or 'changes excluded' (excluding reallocated subjects) analyses. A significant reduction in relative risk was observed for strokes and severe arrhythmia with an overall decrease from 1.0 to 0.41 (95% confidence interval 0.27-0.61).


CONCLUSIONS
Nifedipine treatment diminished the number of severe clinical outcomes in elderly hypertensives significantly.
Shanghai Institute of Hypertension, Rui Jun Hospital of Shanghai, Shanghai Second Medical University, People's Republic of China.
L
L
Gong
W
W
Zhang
Y
Y
Zhu
J
J
Zhu
D
D
Kong
V
V
Pagé
P
P
Ghadirian
J
J
LeLorier
P
P
Hamet
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015331:Cohort Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D016037:Single-Blind Method
D002121:Calcium Channel Blockers; D009543:Nifedipine