this was a randomised, blinded, controlled trial - there was a 4-year follow-up
the trial was undertaken in 312 health centres in Sweden. There were 6,614 patients recruited into the study. The age of patients recruited varied from 70 to 84 years of age. Hypertension was defined as a systolic blood pressure >= 180 mmHg or diastolic blood pressure >= 105 mmHg or both
patients were allocated to one of three different treatment groups: conventional antihypertensive drugs (betablockers or a thiazide/amiloride preparation); ACE inhibitors; calcium antagonists
outcome measures used in this study were: cardiovascular mortality - the main outcome measure. Secondary outcome measures included fatal and non-fatal MI, fatal and non-fatal stroke
study results - there was no significant difference in cardiovascular mortality, the combined outcome of stroke, or combined outcome of MI between the three groups. When the results of the ACE inhibitors and calcium antagonists were combined (representing the newer antihypertensive drugs) there were no significant differences between the newer and older (beta blockers, thiazides) antihypertensive treatments in terms of cardiovascular events
Reference:
1) Hansson L, Lindholm LH, Ekbom T et al (1999). Randomised trial of old and new antihypertensive drugs in elderly patients: cardiovascular mortality and morbidity the Swedish Trial in Old Patients with Hypertension-2 Study. Lancet, 354, 1751-6.
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