Antihypertensive Therapy Extends Life, First-Time Data Show

Guess whether fat people have a greater likelihood of developing hypertension and "needing" drugs.

Antihypertensive therapy with chlorthalidone-based stepped care therapy was associated with a lower rate of cardiovascular events than placebo, according to findings from the Systolic Hypertension in the Elderly Program (SHEP) trial, which took place from 1985 to 1990. However, the effect of stepped care therapy on mortality was not significant.

A "legacy effect" has been reported in some previous trials, in that the benefit of therapy on hypertension, hyperlipidemia, and diabetes appeared or persisted after the end of the trials when all patients were advised to receive active therapy. The goal of the present study by Kostis and colleagues was to measure the gain in life expectancy at the 22-year follow-up of SHEP participants randomly assigned to active antihypertensive treatment.

The first long-term data from the high-blood-pressure study SHEP show that each month of chlorthalidone-based therapy was associated with approximately one day of extension in life, free from cardiovascular death [1].

"The main findings are that after 22 years of follow-up, when about 60% of the participants in SHEP were dead, we saw a prolonged life expectancy in those who took the active treatment for 4.5 years, and that is the first time this has been reported in studies of hypertension, because you have to wait a long time to find out differences in life expectancy," lead author Dr John B Kostis (UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ) told heartwire .

And how much longer and better would you live if you did not get hypertension?