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The Systolic Hypertension in Europe (Syst-Eur) Trial, 1997

The Systolic Hypertension in Europe (Syst-Eur) Trial, 1997. Syst-Eur Trial. The Syst olic Hypertension in Eur ope (Syst-Eur) Trial enrolled 4,695 patients  60 years old, with hypertension, for a median follow-up of 24 months (range 1-97 months)

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The Systolic Hypertension in Europe (Syst-Eur) Trial, 1997

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  1. The Systolic Hypertension in Europe (Syst-Eur) Trial, 1997

  2. Syst-Eur Trial The Systolic Hypertension in Europe (Syst-Eur) Trial enrolled 4,695 patients 60 years old, with hypertension, for a median follow-up of 24 months (range 1-97 months) Participants were randomly assigned to nitrendipine, plus enalapril and hydrochlorothiazide if needed, or to placebo The primary endpoint was a composite of fatal and non-fatal stroke Other endpoints included congestive heart failure, myocardial infarction, sudden death, and all cardiac endpoints (a composite of congestive heart failure, myocardial infarction and sudden death) 492 patients had diabetes at baseline Staessen JA, et al. Lancet. 1997;350:757-764.

  3. The Systolic Hypertension in Europe Trial, 1997 Staessen JA, et al. Lancet. 1997;350:757-764.

  4. Syst-Eur Mean Sitting Systolic Blood Pressure Placebo (n=2,297) Active treatment (n=2,398) Systolic BP (mmHg) P<0.001 0 1 2 3 4 Years since randomization Syst-Eur=Systolic Hypertension in Europe Trial Staessen JA, et al. Lancet. 1997;350:757-764. Reprinted with permission from Elsevier Science.

  5. Syst-Eur Mean Sitting Diastolic Blood Pressure P<0.001 Diastolic BP (mmHg) Placebo (n=2,297) Active treatment (n=2,398) 0 1 2 3 4 Years since randomization Syst-Eur=Systolic Hypertension in Europe Trial Staessen JA, et al. Lancet. 1997;350:757-764. Reprinted with permission from Elsevier Science.

  6. 2 0 1 3 4 Syst-Eur Primary EndpointFatal and Nonfatal Stroke P=0.003 Placebo (n=2,297) Active treatment (n=2,398) Events per 100 patients Years since randomization Syst-Eur=Systolic Hypertension in Europe Trial Staessen JA, et al. Lancet. 1997;350:757-764. Reprinted with permission from Elsevier Science.

  7. Syst-EurCardiovascular Disease Endpoints Active therapy vs. placebo 14% Percentage relative risk reduction (95% CI) 29% 30% 31% P<0.001 42% P=0.003 Stroke MI CHF All CVD Death MI=myocardial infarction; CHF=congestive heart failure; CVD=cardiovascular disease Syst-Eur=Systolic Hypertension in Europe Trial Staessen JA, et al. Lancet. 1997;350:757-764.

  8. Syst-Eur Fatal and Non-Fatal Endpoints Combined All cardiovascular endpoints Cardiac endpoints* Heart failure Myocardial infarction Stroke % relative risk reduction - 26 - 29 - 30 - 31 P=0.03 P=0.12 P=0.12 P<0.001 - 42 P=0.003 *Includes fatal and non-fatal heart failure, fatal and non-fatal myocardial infarction, and sudden death Staessen JA, et al. Lancet. 1997;350:757-764.

  9. Diabetic (n=492) Nondiabetic (n=4,203) Syst-Eur Outcomes in Diabetic and Nondiabetic Patients Mortality from cardiovascular causes All Cardiovascular events* Overall mortality % relative risk reduction P=0.04 P=0.02 P=0.01 *Includes fatal and non-fatal events Tuomilehto J, et al. N Eng J Med. 1999;340:677-684.

  10. Syst-Eur Conclusions • Older men and women with isolated systolic hypertension who received active treatment with a dihydropyridine calcium channel blocker experienced fewer strokes and cardiovascular disease (CVD) events than those receiving placebo. • Treatment of 1,000 patients for 5 years with this type of regimen could prevent 29 strokes or 53 major CVD endpoints. Syst-Eur=Systolic Hypertension in Europe Trial Staessen JA, et al. Lancet. 1997;350:757-764.

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