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.”

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

  1. William DeMedio, MD says:

    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