Influence of Antihypertensive Drug Treatment on Morbidity and Mortality in Patients Over the Age of 60 Years. EWPHE Results: Sub-Group Analysis Based on Entry Stratification

The European Working Party on High blood pressure in Ihe Elderly (EWPHE) lrial was a double-blind randomized placebo-controlled lrial of antihypertensive treatment in patienls over the age of 60 years. Entry criteria included both a sitting diastolic blood pressure on placebo lreatmenl in the range of 90-1 19 rnmHg and a systolic blood pressure in the range of 160-239 mmHg. Eight-hundred and forty patients were rar~domly assigned either to aclive lreatmenl (hydrochlorothiazide + Iriamlerene) or a matching placebo. If blood pressure remained elevated methyldopa was added to the aclive regimen and matching placebo to the placebo regimen. Before randomization, Ihe patienls were stratified in eight strata according to sex, age groups belween 60 and 69 years or 70 years and over, and the presence or absence of cardiovascular complications of hypertension, Bolh the intention-lo-treat and 'on randomized Irealmenl' analyses suggested a benefit from aclive lreatment in men and women. Formal statistical significance was achieved for male cardiovascular mortality (intention-to-treat analyses) and for cardio- vascular events in females. Although Ihe even1 rales were greater for palienls with previous cardiovascular events and patients over Ihe age of 70 years. Ihe percenlage reduction in cardiovas-