Cited by 2,953Blood Pressure and Hypertension StudiesCardiovascular Health and Disease PreventionSodium Intake and Health

The DOI matches its Crossref record.

Prevention of Stroke by Antihypertensive Drug Treatment in Older Persons With Isolated Systolic Hypertension: Final Results of the Systolic Hypertension in the Elderly Program (SHEP)

·1991·JAMA

DOI 10.1001/jama.1991.03460240051027

Open this paper in CoChat — free account

Abstract

Objective.— To assess the ability of antihypertensive drug treatment to reduce the risk of nonfatal and fatal (total) stroke in isolated systolic hypertension. Design.— Multicenter, randomized, double-blind, placebo-controlled. Setting.— Community-based ambulatory population in tertiary care centers. Participants.— 4736 persons (1.06%) from 447 921 screenees aged 60 years and above were randomized (2365 to active treatment, 2371 to placebo). Systolic blood pressure ranged from 160 to 219 mm Hg and diastolic blood pressure was less than 90 mm Hg. Of the participants, 3161 were not receiving antihypertensive medication at initial contact, and 1575 were. The average systolic blood pressure was 170 mm Hg; average diastolic blood pressure, 77 mm Hg. The mean age was 72 years, 57% were women, and 14% were black. Interventions.— Participants were stratified by clinical center and by antihypertensive medication status at initial contact. For step 1 of the trial, dose 1 was chlorthalidone, 12.5 mg/d, or matching placebo; dose 2 was 25 mg/d. For step 2, dose 1 was atenolol, 25 mg/d, or matching placebo; dose 2 was 50 mg/d. Main Outcome Measures.— Primary.—Nonfatal and fatal (total) stroke.Secondary.— Cardiovascular and coronary morbidity and mortality, all-cause mortality, and quality of life measures. Results.— Average follow-up was 4.5 years. The 5-year average systolic blood pressure was 155 mm Hg for the placebo group and 143 mm Hg for the active treatment group, and the 5-year average diastolic blood pressure was 72 and 68 mm Hg, respectively. The 5-year incidence of total stroke was 5.2 per 100 participants for active treatment and 8.2 per 100 for placebo. The relative risk by proportional hazards regression analysis was 0.64 (P=.0003). For the secondary end point of clinical nonfatal myocardial infarction plus coronary death, the relative risk was 0.73. Major cardiovascular events were reduced (relative risk, 0.68). For deaths from all causes, the relative risk was 0.87. Conclusion.— In persons aged 60 years and over with isolated systolic hypertension, antihypertensive stepped-care drug treatment with low-dose chlorthalidone as step 1 medication reduced the incidence of total stroke by 36%, with 5-year absolute benefit of 30 events per 1000 participants. Major cardiovascular events were reduced, with 5-year absolute benefit of 55 events per 1000. (JAMA. 1991;265:3255-3264)

Integrity signals

Registry

Crossref · 10.1001/jama.1991.03460240051027

Cites

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Sorted by citations

Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., Jones, D. W., Materson, B. J., Oparil, S., Wright, J. T., et al. (2003) · Hypertension · doi:10.1161/01.hyp.0000107251.49515.c2 · Cited by 13,271
2018 ESC/ESH Guidelines for the management of arterial hypertension
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy339 · Cited by 10,286
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391
A Randomized Trial of Intensive versus Standard Blood-Pressure Control
The SPRINT Research Group (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1511939 · Cited by 6,325
Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
Kernan, W. N., Ovbiagele, B., Black, H. R., Bravata, D. M., Chimowitz, M. I., Ezekowitz, M. D., Fang, M. C., Fisher, M., Furie, K. L., Heck, D. V., et al. (2014) · Stroke · doi:10.1161/str.0000000000000024 · Cited by 5,170
Vascular Contributions to Cognitive Impairment and Dementia: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
Gorelick, P. B., Scuteri, A., Black, S. E., DeCarli, C., Greenberg, S. M., Iadecola, C., Launer, L. J., Laurent, S., Lopez, O. L., Nyenhuis, D., et al. (2011) · Stroke · doi:10.1161/str.0b013e3182299496 · Cited by 3,811
Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis
Ettehad, D., Emdin, C. A., Kiran, A., Anderson, S. G., Callender, T., Emberson, J., Chalmers, J., Rodgers, A., & Rahimi, K. (2016) · The Lancet · doi:10.1016/s0140-6736(15)01225-8 · Cited by 3,755
2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)
Mancia, G., Kreutz, R., Brunström, M., Burnier, M., Grassi, G., Januszewicz, A., Muiesan, M. L., Tsioufis, K., Agabiti-Rosei, E., Algharably, E. A. E., et al. (2023) · Journal of Hypertension · doi:10.1097/hjh.0000000000003480 · Cited by 3,473
Treatment of hypertension in patients 80 years of age or older
Beckett, N. S., Peters, R., Fletcher, A. E., Staessen, J. A., Liu, L., Dumitrascu, D., Stoyanovsky, V., Antikainen, R. L., Nikitin, Y., Anderson, C., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0801369 · Cited by 3,092
Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension
Staessen, J. A., Fagard, R., Thijs, L., Celis, H., Arabidze, G. G., Birkenhäger, W. H., Bulpitt, C. J., de Leeuw, P. W., Dollery, C. T., Fletcher, A. E., et al. (1997) · The Lancet · doi:10.1016/s0140-6736(97)05381-6 · Cited by 2,989
2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension
Williams, B., Mancia, G., Spiering, W., Agabiti Rosei, E., Azizi, M., Burnier, M., Clement, D. L., Coca, A., de Simone, G., Dominiczak, A., et al. (2018) · Journal of Hypertension · doi:10.1097/hjh.0000000000001940 · Cited by 2,885
Guidelines for the Primary Prevention of Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
Meschia, J. F., Bushnell, C., Boden-Albala, B., Braun, L. T., Bravata, D. M., Chaturvedi, S., Creager, M. A., Eckel, R. H., Elkind, M. S. V., Fornage, M., et al. (2014) · Stroke · doi:10.1161/str.0000000000000046 · Cited by 2,650
US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008
Egan, B. M. (2010) · JAMA · doi:10.1001/jama.2010.650 · Cited by 2,197
Long-term trends in the incidence of and survival with heart failure
Levy, D., Kenchaiah, S., Larson, M. G., Benjamin, E. J., Kupka, M. J., Ho, K. K. L., Murabito, J. M., & Vasan, R. S. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa020265 · Cited by 2,152
High blood pressure and cardiovascular disease
Fuchs, F. D., & Whelton, P. K. (2020) · Hypertension · doi:10.1161/hypertensionaha.119.14240 · Cited by 1,948
Mechanisms, Pathophysiology, and Therapy of Arterial Stiffness
Zieman, S. J., Melenovsky, V., & Kass, D. A. (2005) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/01.atv.0000160548.78317.29 · Cited by 1,854
AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update: A Guideline From the American Heart Association and American College of Cardiology Foundation
Smith, S. C., Benjamin, E. J., Bonow, R. O., Braun, L. T., Creager, M. A., Franklin, B. A., Gibbons, R. J., Grundy, S. M., Hiratzka, L. F., Jones, D. W., et al. (2011) · Circulation · doi:10.1161/cir.0b013e318235eb4d · Cited by 1,759
Spontaneous intracerebral hemorrhage
Qureshi, A. I., Tuhrim, S., Broderick, J. P., Batjer, H. H., Hondo, H., & Hanley, D. F. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105103441907 · Cited by 1,719
Epidemiology of Alzheimer disease
Reitz, C., Brayne, C., & Mayeux, R. (2011) · Nature Reviews Neurology · doi:10.1038/nrneurol.2011.2 · Cited by 1,675
Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document
Mancia, G., Laurent, S., Agabiti-Rosei, E., Ambrosioni, E., Burnier, M., Caulfield, M. J., Cifkova, R., Clément, D., Coca, A., Dominiczak, A., et al. (2009) · Journal of Hypertension · doi:10.1097/hjh.0b013e328333146d · Cited by 1,643
The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective
Mahmood, S. S., Levy, D., Vasan, R. S., & Wang, T. J. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61752-3 · Cited by 1,622
Metformin: An Old Drug for the Treatment of Diabetes But a New Drug for the Protection of the Endothelium
Kinaan, M., Ding, H., & Triggle, C. R. (2015) · Medical Principles and Practice · doi:10.1159/000381643 · Cited by 1,515
Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial
Forette, F., Seux, M.-L., Staessen, J. A., Thijs, L., Birkenhäger, W. H., Babarskiene, M.-R., Babeanu, S., Bossini, A., Gil-Extremera, B., Girerd, X., et al. (1998) · The Lancet · doi:10.1016/s0140-6736(98)03086-4 · Cited by 1,441
Does the Relation of Blood Pressure to Coronary Heart Disease Risk Change With Aging?: The Framingham Heart Study
Franklin, S. S., Larson, M. G., Khan, S. A., Wong, N. D., Leip, E. P., Kannel, W. B., & Levy, D. (2001) · Circulation · doi:10.1161/01.cir.103.9.1245 · Cited by 1,390
Genome-wide association study of blood pressure and hypertension
Levy, D., Ehret, G. B., Rice, K., Verwoert, G. C., Launer, L. J., Dehghan, A., Glazer, N. L., Morrison, A. C., Johnson, A. D., Aspelund, T., et al. (2009) · Nature Genetics · doi:10.1038/ng.384 · Cited by 1,364
Pathophysiology and treatment of stroke: present status and future perspectives
Kuriakose, D., & Xiao, Z. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21207609 · Cited by 1,350
Guidelines for the Primary Prevention of Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
Goldstein, L. B., Bushnell, C. D., Adams, R. J., Appel, L. J., Braun, L. T., Chaturvedi, S., Creager, M. A., Culebras, A., Eckel, R. H., Hart, R. G., et al. (2011) · Stroke · doi:10.1161/str.0b013e3181fcb238 · Cited by 1,306
Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention
Qiu, C., Kivipelto, M., & von Strauss, E. (2009) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2009.11.2/cqiu · Cited by 1,261
The age-dependent relation of blood pressure to cognitive function and dementia
Qiu, C., Winblad, B., & Fratiglioni, L. (2005) · The Lancet Neurology · doi:10.1016/s1474-4422(05)70141-1 · Cited by 1,138
A Comparison of Outcomes with Angiotensin-Converting–Enzyme Inhibitors and Diuretics for Hypertension in the Elderly
Wing, L. M. H., Reid, C. M., Ryan, P., Beilin, L. J., Brown, M. A., Jennings, G. L. R., Johnston, C. I., McNeil, J. J., Macdonald, G. J., Marley, J. E., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa021716 · Cited by 1,130
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000596 · Cited by 1,127
Clinical Practice Guidelines for the Management of Hypertension in the Community: A Statement by the American Society of Hypertension and the International Society of Hypertension
Weber, M. A., Schiffrin, E. L., White, W. B., Mann, S., Lindholm, L. H., Kenerson, J. G., Flack, J. M., Carter, B. L., Materson, B. J., Ram, C. V. S., et al. (2014) · The Journal of Clinical Hypertension · doi:10.1111/jch.12237 · Cited by 986
2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., Douglas, P. S., Foody, J. M., Gerber, T. C., Hinderliter, A. L., et al. (2012) · Circulation · doi:10.1161/cir.0b013e318277d6a0 · Cited by 845
Pulse pressure—a review of mechanisms and clinical relevance
Dart, A. M., & Kingwell, B. A. (2001) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(01)01108-1 · Cited by 836
Factors Influencing the Decline in Stroke Mortality: A Statement From the American Heart Association/American Stroke Association
Lackland, D. T., Roccella, E. J., Deutsch, A. F., Fornage, M., George, M. G., Howard, G., Kissela, B. M., Kittner, S. J., Lichtman, J. H., Lisabeth, L. D., et al. (2014) · Stroke · doi:10.1161/01.str.0000437068.30550.cf · Cited by 815
Trial of Intensive Blood-Pressure Control in Older Patients with Hypertension
Zhang, W., Zhang, S., Deng, Y., Wu, S., Ren, J., Sun, G., Yang, J., Jiang, Y., Xu, X., Wang, T.-D., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2111437 · Cited by 784
Incident dementia and blood pressure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo controlled trial
Peters, R., Beckett, N., Forette, F., Tuomilehto, J., Clarke, R., Ritchie, C., Waldman, A., Walton, I., Poulter, R., Ma, S., et al. (2008) · The Lancet Neurology · doi:10.1016/s1474-4422(08)70143-1 · Cited by 770
Long-term follow-up after tight control of blood pressure in type 2 diabetes
Holman, R. R., Paul, S. K., Bethel, M. A., Neil, H. A. W., & Matthews, D. R. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0806359 · Cited by 762
Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association
Iadecola, C., Yaffe, K., Biller, J., Bratzke, L. C., Faraci, F. M., Gorelick, P. B., Gulati, M., Kamel, H., Knopman, D. S., Launer, L. J., et al. (2016) · Hypertension · doi:10.1161/hyp.0000000000000053 · Cited by 746
Effects of antihypertensive-drug class on interindividual variation in blood pressure and risk of stroke: a systematic review and meta-analysis
Webb, A. J., Fischer, U., Mehta, Z., & Rothwell, P. M. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60235-8 · Cited by 729
Primary Prevention of Coronary Heart Disease: Guidance From Framingham: A Statement for Healthcare Professionals From the AHA Task Force on Risk Reduction
Grundy, S. M., Balady, G. J., Criqui, M. H., Fletcher, G., Greenland, P., Hiratzka, L. F., Houston-Miller, N., Kris-Etherton, P., Krumholz, H. M., LaRosa, J., et al. (1998) · Circulation · doi:10.1161/01.cir.97.18.1876 · Cited by 609
Joint British Societies' consensus recommendations for the prevention of cardiovascular disease (JBS3)
JBS3 Board (2014) · Heart · doi:10.1136/heartjnl-2014-305693 · Cited by 608
Atenolol in hypertension: is it a wise choice?
Carlberg, B., Samuelsson, O., & Lindholm, L. H. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17355-8 · Cited by 562
Peripheral Arterial Disease: Morbidity and Mortality Implications
Golomb, B. A., Dang, T. T., & Criqui, M. H. (2006) · Circulation · doi:10.1161/circulationaha.105.593442 · Cited by 498
Comparative Antihypertensive Effects of Hydrochlorothiazide and Chlorthalidone on Ambulatory and Office Blood Pressure
Ernst, M. E., Carter, B. L., Goerdt, C. J., Steffensmeier, J. J. G., Phillips, B. B., Zimmerman, M. B., & Bergus, G. R. (2006) · Hypertension · doi:10.1161/01.hyp.0000203309.07140.d3 · Cited by 433
Vascular risk factors and dementia: How to move forward?
Viswanathan, A., Rocca, W. A., & Tzourio, C. (2009) · Neurology · doi:10.1212/01.wnl.0000341271.90478.8e · Cited by 414
Defining the relationship between hypertension, cognitive decline, and dementia: a review
Walker, K. A., Power, M. C., & Gottesman, R. F. (2017) · Current Hypertension Reports · doi:10.1007/s11906-017-0724-3 · Cited by 394
Effects of blood pressure lowering on outcome incidence in hypertension. 1. Overview, meta-analyses, and meta-regression analyses of randomized trials
Thomopoulos, C., Parati, G., & Zanchetti, A. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000378 · Cited by 388
Effects of aspirin plus extended-release dipyridamole versus clopidogrel and telmisartan on disability and cognitive function after recurrent stroke in patients with ischaemic stroke in the Prevention Regimen for Effectively Avoiding Second Strokes (PRoFESS) trial: a double-blind, active and placebo-controlled study
Diener, H.-C., Sacco, R. L., Yusuf, S., Cotton, D., Ôunpuu, S., Lawton, W. A., Palesch, Y., Martin, R. H., Albers, G. W., Bath, P., et al. (2008) · The Lancet Neurology · doi:10.1016/s1474-4422(08)70198-4 · Cited by 359
Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes
Kostis, J. B., Wilson, A. C., Freudenberger, R. S., Cosgrove, N. M., Pressel, S. L., & Davis, B. R. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2004.08.059 · Cited by 325
Elevated systolic blood pressure and risk of cardiovascular and renal disease: overview of evidence from observational epidemiologic studies and randomized controlled trials
He, J., & Whelton, P. K. (1999) · American Heart Journal · doi:10.1016/s0002-8703(99)70312-1 · Cited by 325
Observational research--opportunities and limitations
Boyko, E. J. (2013) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2013.07.007 · Cited by 313
Effects of blood pressure lowering on outcome incidence in hypertension: 7. Effects of more vs. less intensive blood pressure lowering and different achieved blood pressure levels – updated overview and meta-analyses of randomized trials
Thomopoulos, C., Parati, G., & Zanchetti, A. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000000881 · Cited by 298
Benefits of cardiac rehabilitation and exercise training in secondary coronary prevention in the elderly
Lavie, C. J., Milani, R. V., & Littman, A. B. (1993) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(93)90176-2 · Cited by 267
Current evidence supporting the role of diuretics in heart failure: a meta analysis of randomised controlled trials
Faris, R., Flather, M., Purcell, H., Henein, M., Poole-Wilson, P., & Coats, A. (2002) · International Journal of Cardiology · doi:10.1016/s0167-5273(01)00600-3 · Cited by 260
Hypertension is a potential risk factor for vascular dementia: systematic review
Sharp, S. I., Aarsland, D., Day, S., Sønnesyn, H., Alzheimer's Society Vascular Dementia Systematic Review Group, & Ballard, C. (2011) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2572 · Cited by 241
Cardiovascular risk factors and dementia
Fillit, H., Nash, D. T., Rundek, T., & Zuckerman, A. (2008) · The American Journal of Geriatric Pharmacotherapy · doi:10.1016/j.amjopharm.2008.06.004 · Cited by 225
Dementia, stroke, and vascular risk factors; a review
Sahathevan, R., Brodtmann, A., & Donnan, G. A. (2012) · International Journal of Stroke · doi:10.1111/j.1747-4949.2011.00731.x · Cited by 230
Large and Small Artery Cross-Talk and Recent Morbidity-Mortality Trials in Hypertension
Laurent, S., Briet, M., & Boutouyrie, P. (2009) · Hypertension · doi:10.1161/hypertensionaha.109.133116 · Cited by 217
Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10 – Should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials
Thomopoulos, C., Parati, G., & Zanchetti, A. (2017) · Journal of Hypertension · doi:10.1097/hjh.0000000000001276 · Cited by 206
Circadian variation in stroke onset: identical temporal pattern in ischemic and hemorrhagic events
Manfredini, R., Boari, B., Smolensky, M. H., Salmi, R., la Cecilia, O., Maria Malagoni, A., Haus, E., & Manfredini, F. (2005) · Chronobiology International · doi:10.1081/cbi-200062927 · Cited by 197
Dementia and Disability Outcomes in Large Hypertension Trials: Lessons Learned from the Systolic Hypertension in the Elderly Program (SHEP) Trial
Di Bari, M., Pahor, M., Franse, L. V., Shorr, R. I., Wan, J. Y., Ferrucci, L., Somes, G. W., & Applegate, W. B. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.1.72 · Cited by 193
Cardiovascular drug therapy in the elderly: benefits and challenges
Fleg, J. L., Aronow, W. S., & Frishman, W. H. (2011) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2010.162 · Cited by 186
Treatment of hypertension in patients 80 years and older: the lower the better? A meta-analysis of randomized controlled trials
Bejan-Angoulvant, T., Saadatian-Elahi, M., Wright, J. M., Schron, E. B., Lindholm, L. H., Fagard, R., Staessen, J. A., & Gueyffier, F. (2010) · Journal of Hypertension · doi:10.1097/hjh.0b013e328339f9c5 · Cited by 178
Blood pressure and the risk for dementia—A double edged sword
Kennelly, S. P., Lawlor, B. A., & Kenny, R. A. (2009) · Ageing Research Reviews · doi:10.1016/j.arr.2008.11.001 · Cited by 173
Microvascular brain damage with aging and hypertension: pathophysiological consideration and clinical implications
Scuteri, A., Nilsson, P. M., Tzourio, C., Redon, J., & Laurent, S. (2011) · Journal of Hypertension · doi:10.1097/hjh.0b013e328347cc17 · Cited by 151
Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis
Peters, R., Xu, Y., Fitzgerald, O., Aung, H. L., Beckett, N., Bulpitt, C., Chalmers, J., Forette, F., Gong, J., Harris, K., et al. (2022) · European Heart Journal · doi:10.1093/eurheartj/ehac584 · Cited by 142
Hypertension in the Parsi community of Bombay: a study on prevalence, awareness and compliance to treatment
Bharucha, N. E., & Kuruvilla, T. (2003) · BMC Public Health · doi:10.1186/1471-2458-3-1 · Cited by 143
Diuretics for Hypertension: A Review and Update
Roush, G. C., & Sica, D. A. (2016) · American Journal of Hypertension · doi:10.1093/ajh/hpw030 · Cited by 142
Smoking and caffeine have a synergistic detrimental effect on aortic stiffness and wave reflections
Vlachopoulos, C., Kosmopoulou, F., Panagiotakos, D., Ioakeimidis, N., Alexopoulos, N., Pitsavos, C., & Stefanadis, C. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.07.049 · Cited by 135
Differential blood pressure effects of ibuprofen, naproxen, and celecoxib in patients with arthritis: the PRECISION-ABPM (Prospective Randomized Evaluation of Celecoxib Integrated Safety Versus Ibuprofen or Naproxen Ambulatory Blood Pressure Measurement) Trial
Ruschitzka, F., Borer, J. S., Krum, H., Flammer, A. J., Yeomans, N. D., Libby, P., Lüscher, T. F., Solomon, D. H., Husni, M. E., Graham, D. Y., et al. (2017) · European Heart Journal · doi:10.1093/eurheartj/ehx508 · Cited by 130
Prevalence, Correlates, and Prognosis of Healthy Vascular Aging in a Western Community-Dwelling Cohort: The Framingham Heart Study
Niiranen, T. J., Lyass, A., Larson, M. G., Hamburg, N. M., Benjamin, E. J., Mitchell, G. F., & Vasan, R. S. (2017) · Hypertension · doi:10.1161/hypertensionaha.117.09026 · Cited by 126
Genesis of the normal and abnormal arterial pulse
Vlachopoulos, C., & O'Rourke, M. (2000) · Current Problems in Cardiology · doi:10.1067/mcd.2000.104057 · Cited by 125
Chronic Management of Blood Pressure After Stroke
Pedelty, L., & Gorelick, P. B. (2004) · Hypertension · doi:10.1161/01.hyp.0000129170.50448.5f · Cited by 122
Effects of a New Hormone Therapy, Drospirenone and 17-β-Estradiol, in Postmenopausal Women With Hypertension
White, W. B., Hanes, V., Chauhan, V., & Pitt, B. (2006) · Hypertension · doi:10.1161/01.hyp.0000232179.60442.84 · Cited by 119
Selective Antihypertensive Dihydropyridines Lower Aβ Accumulation by Targeting both the Production and the Clearance of Aβ across the Blood-Brain Barrier
Paris, D., Bachmeier, C., Patel, N., Quadros, A., Volmar, C.-H., Laporte, V., Ganey, J., Beaulieu-Abdelahad, D., Ait-Ghezala, G., Crawford, F., et al. (2011) · Molecular Medicine · doi:10.2119/molmed.2010.00180 · Cited by 114
Clinical Outcomes by Race in Hypertensive Patients With and Without the Metabolic Syndrome<subtitle>Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT)</subtitle>
Wright, J. T. (2008) · Archives of Internal Medicine · doi:10.1001/archinternmed.2007.66 · Cited by 114
Nonpharmacologic Intervention to Reduce Blood Pressure in Older Patients With Mild Hypertension
Applegate, W. B., Miller, S. T., Elam, J. T., Cushman, W. C., El Derwi, D., Brewer, A., & Graney, M. J. (1992) · Archives of Internal Medicine · doi:10.1001/archinte.1992.00400180034005 · Cited by 106
The Study on COgnition and Prognosis in the Elderly (SCOPE); outcomes in patients not receiving add-on therapy after randomization
Lithell, H., Hansson, L., Skoog, I., Elmfeldt, D., Hofman, A., Olofsson, B., Trenkwalder, P., & Zanchetti, A. (2004) · Journal of Hypertension · doi:10.1097/01.hjh.0000133730.47372.4c · Cited by 104
Pressure-Altering Agents Affect Central Aortic Pressures More Than Is Apparent From Upper Limb Measurements in Hypertensive Patients: The Role of Arterial Wave Reflections
Vlachopoulos, C., Hirata, K., & O’Rourke, M. F. (2001) · Hypertension · doi:10.1161/hy1201.098767 · Cited by 102
Metabolic Depression: A Chronic Depressive Subtype? Findings From the InCHIANTI Study of Older Persons
Vogelzangs, N., Beekman, A. T. F., Boelhouwer, I. G., Bandinelli, S., Milaneschi, Y., Ferrucci, L., & Penninx, B. W. J. H. (2011) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.10m06559 · Cited by 100
Timeline of History of Hypertension Treatment
Saklayen, M. G., & Deshpande, N. V. (2016) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2016.00003 · Cited by 96
Antihypertensive Efficacy of Hydrochlorothiazide vs Chlorthalidone Combined with Azilsartan Medoxomil
Bakris, G. L., Sica, D., White, W. B., Cushman, W. C., Weber, M. A., Handley, A., Song, E., & Kupfer, S. (2012) · The American Journal of Medicine · doi:10.1016/j.amjmed.2012.05.023 · Cited by 90
Midnight serum cortisol as a marker of increased cardiovascular risk in patients with a clinically inapparent adrenal adenoma
Terzolo, M., Bovio, S., Pia, A., Conton, P. A., Reimondo, G., Dall’Asta, C., Bemporad, D., Angeli, A., Opocher, G., Mannelli, M., et al. (2005) · European Journal of Endocrinology · doi:10.1530/eje.1.01959 · Cited by 89
Antihypertensive medication classes and the risk of dementia: a systematic review and network meta-analysis
den Brok, M. G. H. E., van Dalen, J. W., Abdulrahman, H., Larson, E. B., van Middelaar, T., van Gool, W. A., Moll van Charante, E. P., & Richard, E. (2021) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2020.12.019 · Cited by 84
Diuretic antihypertensive drugs and incident dementia risk: a systematic review, meta-analysis and meta-regression of prospective studies
Tully, P. J., Hanon, O., Cosh, S., & Tzourio, C. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000000868 · Cited by 82
Effect of Caffeine on Aortic Elastic Properties and Wave Reflection
Vlachopoulos, C., Hirata, K., & O'Rourke, M. F. (2003) · Journal of Hypertension · doi:10.1097/00004872-200303000-00022 · Cited by 79
Heart disease and aging
Aronow, W. S. (2006) · Medical Clinics of North America · doi:10.1016/j.mcna.2006.05.009 · Cited by 68
Epidemiological Perspective of Body Position and Arm Level in Blood Pressure Measurement
Terént, A., & Breig-åsberg, E. (1994) · Blood Pressure · doi:10.3109/08037059409102246 · Cited by 70
Blood pressure and dementia: What the SPRINT-MIND trial adds and what we still need to know
Peters, R., Warwick, J., Anstey, K. J., & Anderson, C. S. (2019) · Neurology · doi:10.1212/wnl.0000000000007543 · Cited by 68
Diabetes and Cardiovascular Disease Prevention in Older Adults
Cigolle, C. T., Blaum, C. S., & Halter, J. B. (2009) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2009.09.001 · Cited by 50
Second Australian National Blood Pressure Study (ANBP2). Australian Comparative Outcome Trial of ACE inhibitor- and diuretic-based treatment of hypertension in the elderly. Management Committee on Behalf of the High Blood Pressure Research Council of Australia
Wing, L. M. H., Reid, C. M., Ryan, P., Beilin, L. J., Brown, M. A., Jennings, G. L. R., Johnston, C. I., McNeil, J. J., Marley, J. E., Morgan, T. O., et al. (1997) · Clinical and Experimental Hypertension · doi:10.3109/10641969709083186 · Cited by 49
Identification of Risk Factors in Hypertensive Patients: Contribution of Randomized Controlled Trials Through an Individual Patient Database
Gueyffier, F., Boissel, J.-P., Pocock, S., Boutitie, F., Coope, J., Cutler, J., Ekbom, T., Fagard, R., Friedman, L., Kerlikowske, K., et al. (1999) · Circulation · doi:10.1161/01.cir.100.18.e88 · Cited by 46
First-line diuretics versus other classes of antihypertensive drugs for hypertension
Reinhart, M., Puil, L., Salzwedel, D. M., & Wright, J. M. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008161.pub3 · Cited by 38
Twenty-Four Hour Antihypertensive Efficacy of Indapamide, 1.5-Mg Sustained Release: Results of Two Randomized Double-Blind Controlled Studies
Mallion, J.-M., Asmar, R., Boutelant, S., & Guez, D. (1998) · Journal of Cardiovascular Pharmacology · doi:10.1097/00005344-199810000-00023 · Cited by 32
Blood Pressure Control Provides Less Cardiovascular Protection in Adults With Than Without Apparent Treatment‐Resistant Hypertension
Egan, B. M., Kai, B., Wagner, C. S., Henderson, J. H., Chandler, A. H., & Sinopoli, A. (2016) · The Journal of Clinical Hypertension · doi:10.1111/jch.12773 · Cited by 32
Efficacy and safety of two treatment combinations of hypertension in very elderly patients
Fogari, R., Zoppi, A., Mugellini, A., Corradi, L., Lazzari, P., Preti, P., & Derosa, G. (2009) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2008.03.012 · Cited by 33
Clinical Implications of Nonopioid Analgesia for Relief of Mild-to-Moderate Pain in Patients with or at Risk for Cardiovascular Disease
Whelton, A. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2006.02.017 · Cited by 29
Evidence-based Diuretics: Focus On Chlorthalidone and Indapamide
DiNicolantonio, J. J., Bhutani, J., Lavie, C. J., & O’Keefe, J. H. (2015) · Future Cardiology · doi:10.2217/fca.14.83 · Cited by 29
Economic evaluation of primary prevention of cardiovascular diseases in mild hypertension: a scenario analysis for the Netherlands
Stevanović, J., O’Prinsen, A. C., Verheggen, B. G., Schuiling-Veninga, N., Postma, M. J., & Pechlivanoglou, P. (2014) · Clinical Therapeutics · doi:10.1016/j.clinthera.2014.01.008 · Cited by 12

Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 1991-06-26
Volume: 265
Issue: 24
Pages: 3255
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1991.03460240051027
OpenAlex: W4249101651
Cited by: 2,953
References: 0
Citations by year: 2026: 20 · 2025: 25 · 2024: 29 · 2023: 41 · 2022: 34 · 2021: 47 · 2020: 49 · 2019: 56 · 2018: 89 · 2017: 93 · 2016: 88 · 2015: 79 · 2014: 102 · 2013: 89 · 2012: 96
FWCI: 75.99
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords: isolated systolic hypertension, stroke prevention, antihypertensive therapy, chlorthalidone, atenolol, older adults, blood pressure reduction, myocardial infarction, coronary artery disease, all-cause mortality, quality of life, cardiovascular risk reduction, hypertension screening, community-based screening, cardiovascular morbidity and mortality

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Prevention of Stroke by Antihypertensive Drug Treatment in Older Persons With Isolated Systolic Hypertension: Final Results of the Systolic Hypertension in the Elderly Program (SHEP)

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cited by

Related

Metadata

Record

About these checks