Hypertension Therapy Prevents Heart Failure Among Elderly

July 16, 1997

Treatment with a low-dose diuretic cuts by half the chance that an older person with high systolic blood pressure will develop heart failure, according to results from a National Institutes of Health (NIH) trial. Those who had already had a heart attack experienced an even greater benefit--their chance of developing heart failure dropped by 80 percent.

The findings come from the Systolic Hypertension in the Elderly Program (SHEP), a long-term, multi-center trial supported by the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute on Aging (NIA), both units of the NIH. The findings appear in the July 16, 1997, issue of the Journal of the American Medical Association.

"Heart failure has been increasing in the United States in recent years, the only cardiovascular disorder to do so," said NHLBI Director Dr. Claude Lenfant. "There are now about 400,000 new cases annually.

"These findings show that this alarming trend can be reversed," he continued. "Treating hypertension prevents heart failure, even for those with severe heart disease." "These findings are particularly important for older Americans," said Dr. Richard J. Hodes, NIA Director. "Isolated systolic hypertension is the most common form of high blood pressure among people age 60 and older. It is a major risk factor for heart disease and stroke, the number one and number three killers of Americans today."

In isolated systolic hypertension (ISH), the systolic blood pressure is high (140 or greater millimeters of mercury, or mmHg) but the diastolic is normal (less than 90 mmHg). Millions of Americans over age 60 have ISH and more than 3 million have the degree of ISH treated in SHEP--a systolic of 160-219 mmHg and a normal diastolic.

High blood pressure is the chief risk factor for heart failure, which occurs when the heart loses its ability to pump enough blood through the body. Heart failure affects about 4.8 million Americans--3.4 million age 60 or older. It causes about 875,000 hospitalizations a year and is the most common diagnosis for hospital admissions in those age 65 or older. Half of those with heart failure die within 5 years of diagnosis.

Earlier SHEP results showed that treatment with a low-dose diuretic greatly reduces fatal and non-fatal strokes and cardiovascular events among older persons, including those with diabetes. The new findings focus on whether antihypertensive therapy prevents heart failure.

SHEP followed 4,736 men and women, aged 60 and older, for an average of 4.5 years. At the start of the trial, 492 of the patients had already had a heart attack.

Patients were randomly assigned to receive either a placebo or a low-dose diuretic (chlorthalidone) and, if needed, a second drug. The second drug was a low-dose of either a beta blocker (atenolol) or an adrenergic antagonist (reserpine).

Fatal and nonfatal cases of heart failure dropped dramatically with treatment. Even those age 80 and older benefited from treatment. The greatest benefits were for those who had had a heart attack before participating in the trial.

The following SHEP investigators are available to comment on the trial: Dr. John B. Kostis, lead author and Chairman, Department of Medicine, University of Medicine and Dentistry of New Jersey (UMDNJ)--Robert Wood Johnson Medical School, New Brunswick, NJ; Dr. Jeffrey Cutler, Director, NHLBI Clinical Applications and Prevention Program. Also available to comment is Dr. Andre J. Premen, Geriatrics Program, NIA.

To contact Dr. Kostis, call Tom Capezzuto of the UMDNJ News Service Department at (973) 972-7273. Dr. Cutler can be reached through the NHLBI Communications Office at (301) 496-4236 and Dr. Premen through the NIA Public Information Office at (301) 496-1752.

NHLBI press releases, fact sheets, and other materials are available online at the following website: http://www.nhbli.nih.gov/nhlbi/nhlbi.htm.
-end-


NIH/National Heart, Lung and Blood Institute

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.