Chinese Trial on Isolated Systolic Hypertension in the Elderly

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Abstract
IN 1988, THE Collaborative Group Coordinating Center started the placebo-controlled Systolic Hypertension in China (Syst-China) trial to test the hypothesis whether antihypertensive drug treatment could prevent stroke in older Chinese patients with isolated systolic hypertension.1,2 Active treatment was initiated with the dihydropyridine calcium channel blocker nitrendipine,3 with the possible addition of captopril, hydrochlorothiazide, or both drugs. In the recently published intention-to-treat analysis of the Syst-China trial,4 active treatment decreased the stroke rate by 38% (P = .01) from 20.8 to 13.0 end points per 1000 patient-years. In addition, all cardiovascular end points decreased by 37% (P = .004) and all-cause mortality by 39% (P = .003). At the rates observed in the placebo group, treatment of 1000 Chinese patients for 5 years could prevent 39 strokes, 59 major cardiovascular complications, or 55 deaths.4