CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

December 20th, 2011

22 Years Later, Study Shows Life-Prolonging Effect of Antihypertensive Therapy

After more than 20 years, the benefits of antihypertensive therapy are still evident, according to a new paper published in JAMA. John Kostis and colleagues performed a 22-year follow-up study on patients enrolled between 1985 and 1988 in the Systolic Hypertension in the Elderly Program (SHEP) trial.

In 1991, SHEP found that low-dose chlorthalidone in 4736 elderly patients with isolated systolic hypertension reduced the incidence of stroke and major cardiovascular events at 5 years, compared with placebo. Now, with 22 years of follow-up data, the SHEP investigators report that patients who received active treatment during the trial had a significant gain in life expectancy. Each month of active treatment resulted in about one day extra in life expectancy.

Life-expectancy gain:

  • All-cause mortality: 105 days (CI −39 to 242, p=0.07)
  • Cardiovascular death: 158 days (CI 36-287, p=0.009)

At 22 years, overall mortality was not significantly different between the groups, but cardiovascular death was lower with active treatment:

  • All-cause mortality: 59.9% in the active treatment group versus 60.5% in the placebo group (p=0.24)
  • Cardiovascular death:  28.3% versus 31.0% (p=0.03)
In their discussion, the authors said that the “gain in life expectancy is important, because it occurred among persons with a mean age of 72 years at baseline.”

Categories: General, Prevention
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One Response to “22 Years Later, Study Shows Life-Prolonging Effect of Antihypertensive Therapy”

  1. William DeMedio, MD says:
    December 22, 2011 at 10:52 pm

    I thought 72 was real old when that study was published. Now I have a different take on that attitude.

    Competing interests pertaining specifically to this post, comment, or both:
    I’m over 50