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Geriatrics. 1992 Mar;47(3):30-2, 35-8.

Isolated systolic hypertension: lowering the risk of stroke in older patients. SHEP Cooperative Research Group.

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John A. Burns School of Medicine, University of Hawaii.


The Systolic Hypertension in the Elderly Program (SHEP) was the first clinical trial to demonstrate the efficacy of low-dose antihypertensive medication in preventing stroke in older individuals with isolated systolic hypertension (ISH). The trial was multicentered, double-blind, randomized, placebo-controlled and involved 4,736 men and women, black and white, age 60 and over with ISH. Results showed a highly significant 36% reduction in nonfatal plus fatal stroke over 5 years in the group treated with active medication (low-dose chlorthalidone was step one), compared with the placebo group. Nonfatal plus fatal coronary disease and cardiovascular disease were also significantly reduced with antihypertensive medication, by 27% and 32% respectively, and total mortality was lower by 13%.

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