LONG-TERM BLOOD-PRESSURE CONTROL IN OLDER CHINESE PATIENTS WITH ISOLATED SYSTOLIC HYPERTENSION - A PROGRESS REPORT ON THE SYST-CHINA TRIAL

This report on the ongoing double-blind placebo-controlled Syst-China trial investigated whether antihypertensive drug treatment based mainl y on a calcium entry blocker and a converting enzyme inhibitor, would be suitable for maintaining long-term blood pressure (BP) control in o lder Chinese patients (average age: 67 years) with isolated systolic h ypertension (systolic pressure 160-219 mm Hg and diastolic pressure <9 5 mm Hg). Active treatment consisted of nitrendipine (10-40 mg/day) wi th the possible addition of captopril (12.5-50 mg/day) and hydrochloro thiazide (12.5-50 mg/day), as necessary to reduce systolic pressure to a level of 150 mm Hg or lower and by at least 20 mm Hg. Matching plac ebos were used in the control group. This progress analysis was restri cted to BP control up to 3 years of follow-up. The placebo (n = 1134) and active treatment n = 1245) groups had similar characteristics at e nrolment. The sitting BP averaged 170/86 mm Hg. Systolic pressure fell (P < 0.001) on average 8 mm Hg more on active treatment than on place bo and diastolic pressure 3 mm Hg more. Fewer patients remained on mon otherapy in the placebo than in the active treatment group (P < 0.001) ; on placebo the second and third line medications were started more f requently (P < 0.001). This progress report showed that significant BP reduction can be achieved and maintained in older Chinese patients tr eated with a calcium antagonist, associated with a converting-enzyme i nhibitor and a thiazide, as necessary. Whether this BP reduction would result in a clinically meaningful decrease of cardiovascular complica tions is still under investigation.