Document Detail


Target blood pressure for treatment of isolated systolic hypertension in the elderly: valsartan in elderly isolated systolic hypertension study.
MedLine Citation:
PMID:  20530299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In this prospective, randomized, open-label, blinded end point study, we aimed to establish whether strict blood pressure control (<140 mm Hg) is superior to moderate blood pressure control (> or =140 mm Hg to <150 mm Hg) in reducing cardiovascular mortality and morbidity in elderly patients with isolated systolic hypertension. We divided 3260 patients aged 70 to 84 years with isolated systolic hypertension (sitting blood pressure 160 to 199 mm Hg) into 2 groups, according to strict or moderate blood pressure treatment. A composite of cardiovascular events was evaluated for > or =2 years. The strict control (1545 patients) and moderate control (1534 patients) groups were well matched (mean age: 76.1 years; mean blood pressure: 169.5/81.5 mm Hg). Median follow-up was 3.07 years. At 3 years, blood pressure reached 136.6/74.8 mm Hg and 142.0/76.5 mm Hg, respectively. The blood pressure difference between the 2 groups was 5.4/1.7 mm Hg. The overall rate of the primary composite end point was 10.6 per 1000 patient-years in the strict control group and 12.0 per 1000 patient-years in the moderate control group (hazard ratio: 0.89; [95% CI: 0.60 to 1.34]; P=0.38). In summary, blood pressure targets of <140 mm Hg are safely achievable in relatively healthy patients > or = 70 years of age with isolated systolic hypertension, although our trial was underpowered to definitively determine whether strict control was superior to less stringent blood pressure targets.
Authors:
Toshio Ogihara; Takao Saruta; Hiromi Rakugi; Hiroaki Matsuoka; Kazuaki Shimamoto; Kazuyuki Shimada; Yutaka Imai; Kenjiro Kikuchi; Sadayoshi Ito; Tanenao Eto; Genjiro Kimura; Tsutomu Imaizumi; Shuichi Takishita; Hirotsugu Ueshima;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-06-07
Journal Detail:
Title:  Hypertension     Volume:  56     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-15     Completed Date:  2010-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  196-202     Citation Subset:  IM    
Affiliation:
Department of Geriatric Medicine and Nephrology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00151229
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antihypertensive Agents / therapeutic use
Blood Pressure / drug effects*,  physiology
Cardiovascular Diseases / epidemiology
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Follow-Up Studies
Heart Rate
Humans
Hypertension / drug therapy*,  mortality
Male
Medical History Taking
Patient Selection
Proportional Hazards Models
Reference Values
Stroke / epidemiology,  mortality
Systole / drug effects,  physiology*
Tetrazoles / therapeutic use*
Valine / analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine
Investigator
Investigator/Affiliation:
Kazuya Dohmitsu / ; Tsuyoshi Imaizumi / ; Masayuki Itou / ; Fumitada Kamiya / ; Yutaka Kaneko / ; Yutaka Kato / ; Isao Koishikawa / ; Masaaki Koketsu / ; Tetsushi Kosaki / ; Yasunori Maki / ; Takenori Mase / ; Tatsuaki Matsubara / ; Michizo Matsuhisa / ; Akira Mori / ; Masanori Mori / ; Hifumi Nakagawa / ; Goro Narita / ; Hideo Nomura / ; Takahiko Ohya / ; Yasuyoshi Okamoto / ; Koji Sato / ; Sadamu Suzuki / ; Kenji Yamada / ; Shoji Yamakami / ; Naoya Yamamoto / ; Hiroaki Yamamoto / ; Takayuki Yoshida / ; Yasuo Ishida / ; Yasukazu Kimura / ; Yoshinori Abe / ; Michio Fukushi / ; Takemichi Kanazawa / ; Masashi Kato / ; Yasuhiko Nakamura / ; Toyoaki Sasaki / ; Shuichi Seki / ; Hidesada Takahashi / ; Naoki Tamasawa / ; Haruhiko Tanaka / ; Koji Tsukuda / ; Daisuke Azuma / ; Junji Ishida / ; Akio Jujo / ; Masako Kishi / ; Hirohito Koizumi / ; Tohru Nagashima / ; Yuzo Nakamura / ; Satoshi Ohsone / ; Yoko Pearce / ; Shinichiro Tsunoda / ; Shigeru Yamada / ; Kenzo Yoshida / ; Masahiro Hasui / ; Yutaka Kitami / ; Hironori Miyoshi / ; Hajime Ogata / ; Takumi Sumimoto / ; Tamaki Urabe / ; Katsuya Eguchi / ; Tadashi Konoshita / ; Kennou Anai / ; Tetsuaki Inokuchi / ; Kazunori Kuwano / ; Kazushige Nagasawa / ; Masatoshi Nohara / ; Toya Ochi / ; Hirokuni Oba / ; Toshiaki Okamoto / ; Seiichi Tanaka / ; Takeyoshi Tsuiki / ; Hidekazu Umei / ; Takeyuki Yamamoto / ; Shuichi Anno / ; Tadashi Miura / ; Yoshihiro Miyazaki / ; Takeo Nishimaki / ; Yasumichi Sasaki / ; Mutsuko Sato / ; Atsushi Shitara / ; Takashi Yabuki / ; Tominari Asai / ; Koh Fujisawa / ; Naohisa Horibe / ; Ken Imamura / ; Takashi Ogawa / ; Noriyoshi Yamakita / ; Isamu Aizawa / ; Masaharu Hashida / ; Masayuki Horigome / ; Kimio Hoshino / ; Minoru Kanamaru / ; Kojuro Morishita / ; Toshihiro Nagao / ; Fujihisa Numano / ; Toshikazu Sekiguchi / ; Shunroku Sugimoto / ; Masamichi Tachibana / ; Takashi Tajima / ; Minoru Asano / ; Toyoaki Fujita / ; Shigee Hosoya / ; Tadao Inoue / ; Hidetoshi Ishimitsu / ; Katsuhiro Ito / ; Toshiharu Masuoka / ; Kiyoshi Matsuno / ; Hideo Matsuura / ; Toshihiko Miyamoto / ; Tadamasa Murakami / ; Mitsuaki Nakamaru / ; Fumio Okuno / ; Ken Oyamada / ; Toyonori Saiki / ; Nobuya Sasaki / ; Kazuya Shigenobu / ; Norikazu Shigeto / ; Koichi Shinohara / ; Itaru Tanimoto / ; Kazuo Chiba / ; Masanori Fujita / ; Toru Kaji / ; Hajime Kihara / ; Akihiko Matsumoto / ; Hideo Morimoto / ; Fumiaki Nakazawa / ; Kazuaki Oda / ; Shigeri Ohba / ; Shigemitsu Ohno / ; Hiroshi Oimatsu / ; Akira Ozasa / ; Yuichi Sasaki / ; Satoshi Sato / ; Koichi Sotozono / ; Yoshitoki Takagawa / ; Hidero Takasugi / ; Hidesada Tate / ; Yoshio Uehara / ; Masanobu Funamoto / ; Seiji Hamano / ; Takeshi Hayashi / ; Toshio Iwasa / ; Hiroshi Izawa / ; Koji Kondo / ; Kohjiro Makibayashi / ; Senri Mihata / ; Taichi Nakamura / ; Takeshi Ogura / ; Akira Sakata / ; Issei Sano / ; Kazuo Toda / ; Takeshi Tsujino / ; Yusaku Aizawa / ; Yoko Deguchi / ; Mahito Harada / ; Kouichi Inoue / ; Shojiro Ishibashi / ; Takashi Kano / ; Kozo Kurano / ; Satoshi Sato / ; Hitoshi Suzuki / ; Yasuki Takagi / ; Yoshimi Takano / ; Koichi Taya / ; Shinichi Aizumi / ; Kenichi Doniwa / ; Takahiko Igawa / ; Hideaki Ito / ; Hideki Kitatani / ; Munetoshi Matoba / ; Masayuki Matsumoto / ; Kyoichi Matsunuma / ; Hidenobu Michishita / ; Ryusaku Shionoya / ; Hiroshi Takakuwa / ; Yutaka Wakasa / ; Yoshiko Abe / ; Yutaka Fujii / ; Yasuhiko Kawamorita / ; Tsukasa Kikuchi / ; Naoaki Ando / ; Nobuo Fukuda / ; Kohichi Hasegawa / ; Masakazu Kohno / ; Kimiteru Manabe / ; Akihiro Haruzono / ; Yoshito Isayama / ; Hideaki Fujimoto / ; Keiichi Harada / ; Yumiko Ikeda / ; Masahiro Iyori / ; Takashi Kawafune / ; Kozo Kimura / ; Michisuke Kiryu / ; Issei Koga / ; Osamu Kunishima / ; Takeshi Kurihara / ; Masaaki Manaka / ; Hidemitsu Matsuura / ; Takehiko Mikawa / ; Kosuke Minamisawa / ; Hitoshi Mineki / ; Kanichi Mitsuno / ; Naomichi Miyazaki / ; Ken Nemoto / ; Takeo Nishikawa / ; Atsuko Ogata / ; Masahisa Ori / ; Koji Osako / ; Seinosuke Ryu / ; Yukihisa Shibayama / ; Hiroshi Shionoiri / ; Toru Takagishi / ; Hiroshi Yamakawa / ; Hareaki Yamamoto / ; Shinichiro Yokoyama / ; Kenichi Yoshioka / ; Mitsunobu Kawamura / ; Issui Ueta / ; Hiroshi Yamada / ; Ryo Fukami / ; Koji Honjo / ; Yoichiro Ichikawa / ; Akira Sato / ; Noriaki Toyota / ; Kunihiro Doi / ; Takeshi Matsubara / ; Chiaki Nakagawa / ; Ryuichi Nakano / ; Shotaro Nishi / ; Kimikazu Sawai / ; Ken Takenaka / ; Toshio Yasui / ; Takekazu Masuda / ; Shinya Okamoto / ; Shinichiro Okamune / ; Hideharu Okano / ; Nansho Egawa / ; Nobunari Ohtomo / ; Yoshiko Shibata / ; Kenichi Suzuki / ; Yasuyuki Tominaga / ; Yutaka Ezaki / ; Yoshimasa Hayashi / ; Sumito Kariya / ; Hiroki Kitayama / ; Mikio Kodama / ; Takao Mishima / ; Junichi Miyata / ; Junji Nagatomo / ; Akira Sasaki / ; Toshifumi Taguchi / ; Masayuki Tanaka / ; Nakayasu Wake / ; Takeshi Yamaji / ; Hiroshi Yano / ; Naoto Yokota / ; Nobuhiko Ito / ; Yoichi Kakuta / ; Junko Kamijo / ; Toshimichi Kanaki / ; Hiroaki Matsumoto / ; Hideo Nakajima / ; Mikio Ogihara / ; Takashi Takizawa / ; Kazuyuki Yanagibashi / ; Yoshizumi Yazaki / ; Takanori Yonezawa / ; Kenji Ishida / ; Kazumi Ishida / ; Taku Ishimatsu / ; Keiji Iwamoto / ; Masayuki Nakamura / ; Mitsutaka Sato / ; Koichi Tasaki / ; Hidefumi Yamamoto / ; Kazurou Yoshida / ; Masato Yoshioka / ; Yoshiaki Fukuoka / ; Nobushige Ohte / ; Osamu Shiota / ; Kenichi Higuchi / ; Atsuko Katagiri / ; Taku Matsubara / ; Yukifumi Saito / ; Toshihide Shu / ; Shuichi Takahashi / ; Kazuaki Uchiyama / ; Yoshifumi Yamaguchi / ; Takao Fujino / ; Yoshihiro Hirose / ; Keisuke Horiuchi / ; Tadashi Iwao / ; Masahiro Kan / ; Koji Ninomiya / ; Hideaki Ozaki / ; Shinjiro Sato / ; Sumio Watanabe / ; Masaki Fukushima / ; Kazuhiro Harada / ; Yukio Ido / ; Masanori Kahara / ; Hiroshi Nagai / ; Makoto Yamada / ; Kensuke Matsushima / ; Yasutake Hamaguchi / ; Hiroko Hara / ; Toshio Horino / ; Hiroki Ide / ; Kunihiro Ishitani / ; Atsushi Kamitani / ; Takao Kanda / ; Katsutoshi Katahira / ; Yuhei Kawano / ; Ryuji Kikutani / ; Shinichi Kinoshita / ; Hironari Koka / ; Takehiko Koshi / ; Kazuto Kunimi / ; Woon Joo Lee / ; Ryosuke Matsukawa / ; Etsuko Miyazaki / ; Takashi Nabata / ; Shuzo Nagata / ; Hirokazu Nishida / ; Fumio Okamoto / ; Yasushi Okuyama / ; Kazue Oyama / ; Noboru Sakamoto / ; Sadahiro Senpuku / ; Yoshikatsu Tabuchi / ; Katsura Tamai / ; Akira Tanaka / ; Masakazu Teragaki / ; Nobuo Wakaki / ; Jun Yagi / ; Mutsumasa Yanabu / ; Takako Yano / ; Naoki Kojima / ; Shungo Sukehiro / ; Tetsushi Wakiyama / ; Daisuke Furuya / ; Shinsaku Hirosawa / ; Shigehisa Inokuma / ; Naofumi Isogai / ; Kouichi Kanouzawa / ; Yasuyuki Maruyama / ; Kento Mashiko / ; Makiko Matsuyama / ; Kouichi Morita / ; Yoshihiko Naito / ; Takeshi Naito / ; Tatsushige Nishijima / ; Akitaka Nkata / ; Osamu Tanaka / ; Hidetsugu Tokushima / ; Masato Ohnishi / ; Hitoshi Shimoike / ; Shigekatsu Terai / ; Kazunori Uchida / ; Tetsuhiro Yamada / ; Masaaki Honda / ; Akifumi Nakanishi / ; Koji Ogasawara / ; Hiroaki Sugiura / ; Yoshitake Akiyama / ; Michinori Endo / ; Koji Fuchimoto / ; Mutsumi Hakamata / ; Masumi Hakiri / ; Jun Ichiyama / ; Kiyoshi Ide / ; Eisuke Inadama / ; Shigeo Kato / ; Rieko Kondo / ; Masanori Matsubara / ; Tadashi Mikami / ; Kazuo Minai / ; Daiichiro Murata / ; Makoto Ogi / ; Masaaki Oishi / ; Takashi Okada / ; Masazumi Shibata / ; Tomohiko Shigemasa / ; Shigehito Takagi / ; Taira Takagi / ; Naoyuki Takahashi / ; Yoshimi Takahira / ; Hiroshi Takakuwa / ; Akira Yamauchi / ; Akira Yamazaki / ; Akiya Nakamoto / ; Akifumi Ono / ; Motohiko Arizumi / ; Yuichiro Mishiro / ; Yukio Mizuguchi / ; Akira Ohta / ; Kazuto Okagawa / ; Midori Takasugi / ; Soichiro Ueta / ; Kentaro Yata / ; Teruhiko Aoyagi / ; Yoshio Asano / ; Terunao Ashida / ; Michiaki Hiroe / ; Kenjiro Horiuchi / ; Toshihiko Iwamoto / ; Hiroshi Kawabe / ; Kenji Kobayashi / ; Satoshi Koshikawa / ; Kyoji Mishima / ; Makoto Miyairi / ; Toshihisa Miyazaki / ; Norikatsu Mori / ; Masaki Mori / ; Hidehiko Nakahara / ; Hiroyuki Nakamura / ; Koji Nakayama / ; Makio Ogiwara / ; Seishiro Ono / ; Takeshi Ono / ; Masakuni Sugimoto / ; Norihiro Tsuchiya / ; Tomoaki Watanabe / ; Yoshihito Yamada / ; Minoru Yamakado / ; Hiroshi Yamamichi / ; Kenji Yamamoto / ; Kohshi Yumi / ; Makoto Doi / ; Takechika Fujii / ; Yuji Hirokane / ; Nobutoshi Kuno / ; Ryota Moriwaki / ; Hajime Fujita / ; Hidekazu Miyakoshi / ; Teiji Nakagawa / ; Tokio Saeki / ; Hisaya Shirakawa / ; Tetsuji Sumitani / ; Toru Takahashi / ; Akira Hibino / ; Masataka Morishita / ; Shoichi Nakashima / ; Akihiro Saika / ; Junichi Ueda / ; Masakazu Abe / ; Junya Chiba / ; Toshiya Fujita / ; Mineyuki Kagesawa / ; Yuichi Nakayama / ; Biketsu Ra / ; Shintaro Fugono / ; Hideo Fujii / ; Masateru Kouno / ; Kazuhiro Murata / ; Kiryoku Nakamoto / ; Toshitaka Noda / ; Tsuyoshi Okayama / ; Hiroshi Uchiyama / ; Toru Yamamoto / ; Yoshiaki Noda /

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