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Competing cardiovascular and noncardiovascular risks and longevity in the systolic hypertension in the elderly program.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2014 Feb 15; Vol. 113 (4), pp. 676-81. Date of Electronic Publication: 2013 Nov 23. - Publication Year :
- 2014
-
Abstract
- We examined the effect of chlorthalidone-based stepped care on the competing risks of cardiovascular (CV) versus non-CV death in the Systolic Hypertension in the Elderly Program (SHEP). Participants were randomly assigned to chlorthalidone-based stepped-care therapy (n = 2,365) or placebo (n = 2,371) for 4.5 years, and all participants were advised to take active therapy thereafter. At the 22-year follow-up, the gain in life expectancy free from CV death in the active treatment group was 145 days (95% confidence interval [CI] 23 to 260, p = 0.012). The gain in overall life expectancy was smaller (105 days, 95% CI -39 to 242, p = 0.073) because of a 40-day (95% CI -87 to 161) decrease in survival from non-CV death. Compared with an age- and gender-matched cohort, participants had markedly higher overall life expectancy (Wilcoxon p = 0.00001) and greater chance of reaching the ages of 80 (81.3% vs 57.6%), 85 (58.1% vs 37.4%), 90 (30.5% vs 22.0%), 95 (11.9% vs 8.8%), and 100 years (3.7% vs 2.8%). In conclusion, Systolic Hypertension in the Elderly Program participants had higher overall life expectancy than actuarial controls and those randomized to active therapy had longer life expectancy free from CV death but had a small increase in the competing risk of non-CV death.<br /> (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Antihypertensive Agents administration & dosage
Atenolol administration & dosage
Cardiovascular Diseases drug therapy
Chlorthalidone administration & dosage
Female
Humans
Hypertension mortality
Male
Middle Aged
Risk Factors
Survival Analysis
Treatment Outcome
Antihypertensive Agents therapeutic use
Atenolol therapeutic use
Cardiovascular Diseases epidemiology
Chlorthalidone therapeutic use
Hypertension drug therapy
Longevity drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 113
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 24388619
- Full Text :
- https://doi.org/10.1016/j.amjcard.2013.11.013