Clinical Trials
Non-CV mortality increased with DBP below 70 mm Hg in Syst-Eur analysis

Dr. R. Fagard, Belgium

In elderly patients (average age 70 years) a diastolic blood pressure DBP) less than 70 mm Hg was associated with increased non-cardiovascular (CV) mortality, while a DBP less than 50 mm Hg did not increase CV morbidity and mortality. These results were presented by Dr. Robert Fagard (Leuven, Belgium) at the 15th European Meeting of Hypertension in Milan, held from June 17-21, 2005.

These findings came from a further analysis of the Syst-Eur database to assess the relation between on-treatment DBP and outcomes in elderly patients with isolated systolic hypertension. The study patients had a sitting systolic blood pressure (SBP) of 160-219 mm Hg and a DBP < 95 mm Hg. The study drugs were nitrendipine with enalapril or hydroclorothiazide added as needed or placebo.

Of the 4039 active treatment patients, 490 died (248 were cardiovascular deaths) and 492 had a CV event in the 21,402 patient-years follow-up. In the placebo group, there were 129 deaths (66 CV) and 168 CV events in 5219 patient-years follow-up.

For the relative hazard ratio (RHR) calculated for 5 mm Hg categories of DBP, there was no difference in CV mortality or events whether the DBP was above or below the cut-off values. The RHR was 1.43 for a DBP less than 70 mm Hg for non-CV mortality in the active treatment group (p=0.02). There was a similar trend in the placebo group.