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The Systolic Hypertension in the Elderly Program (SHEP): Rationale, Design, Recruitment, and Baseline Data

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How Should Elderly Hypertensive Patients Be Treated?

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Summary

The Systolic Hypertension in the Elderly Program (SHEP) is a randomized, double-blind, placebo-controlled trail to determine if antihypertensive treatment of isolated systolic hypertension (ISH) (systolic blood pressure [SBP] = 160 mmHg, diastolic blood pressure [DBP] < 90 mmHg) reduces the 5-year incidence of fatal and nonfatal stroke. Recruit ment was demanding; however, 4736 persons (target 4800) with ISH, age 60 years and over, were enrolled (1% of those initially contacted) between March 1, 1985 and January 15, 1988. Potential participants were those who met blood pressure criteria or those on antihypertensive medication and without documented diastolic hypertension who had their medication tapered and discontinued (consent obtained from participant and primary care physician) and then met blood pressure criteria.

Eligible participants were randomized to stepped-care therapy with chlorthalidone and atenolol (alternative, reserpine) or matching placebos as first and second steps. Sixty-six percent of participants were not on antihypertensive medication prior to randomization. The group is 38.6% nonblack male, 47.5% nonblack female, 4.5% black male, and 9.3% black female. At baseline the age-range distribution was 41%, 60–69; 45%, 70–79; and 14%, 80 and over (mean 71.6). The cohort’s SBP distribution was 57%, 160–169 mmHg; 27%, 170–179 mmHg; and 16%, 180 mmHg and over, (mean 170.3). The mean DBP was 76.6 mmHg; and 59.8% had codeable baseline electrocardiographic abnormalities. The trial is now in follow-up phase with scheduled termination in 1991.

SHEP Investigators in addition to authors so noted; M. Donald Balufox Albert Einstein College of Medicine; W. Dallas Hall Emory University School of Medicine; Thomas Vogt Kaiser Permanent Center for Health Research; Jeffrey Raines Miami Heart Institute; David Berkson Northwestern University Medical School; Helen Petrovitch Pacific Health Research Institute; John B. Kostis Robert Wood Johnson Medical School; Harold W. Schnaper University of Alabama, Birmingham; Gordon Guthrie University of Kentucky Medical Center; Richard H. Grimm, Jr. University of Minnesota; Robert McDonald University of Pittsburgh; Henry Black Yale University; Kenneth G. Berge Mayo Clinic (Steering Committee Chairman); Eleanor Schron National Heart, Lung, Blood Institute

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Author information

Authors and Affiliations

  1. Clinical Trials Branch, National Heart Lung and Blood Institute, Bethesda, MD, USA

    Jeffrey L. Probstfield

  2. University of Tennessee School of Medicine, Memphis, TN, USA

    William B. Applegate

  3. National Institute on Aging, Bethesda, MD, USA

    J. David Curb & Lot B. Page

  4. University of California School of Medicine at Davis, Davis, CA, USA

    Nemat O. Borhani

  5. University of Texas at Houston School of Public Health, Houston, TX, USA

    C. Morton Hawkins & Barry R. Davis

  6. Prevention and Demonstration Research Branch, National Heart, Lung, and Blood Institute, Bethesda, MD, USA

    Jeffrey A. Cutler

  7. Bowman-Gray School of Medicine, Winston Salem, NC, USA

    Curt D. Furberg

  8. Biostatistics Research Branch, National Heart, Lung, and Blood Institute, Bethesda, MD, USA

    Edward Lakatos

  9. Washington University School of Medicine, St. Louis, MO, USA

    H. Mitchell Perry Jr.

  10. Pacific Medical Center, Medical Research Institute of San Francisco, San Francisco, CA, USA

    W. McFate Smith

Authors
  1. Jeffrey L. Probstfield
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  2. William B. Applegate
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  3. J. David Curb
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  4. Nemat O. Borhani
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  5. C. Morton Hawkins
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  6. Jeffrey A. Cutler
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  7. Barry R. Davis
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  8. Curt D. Furberg
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  9. Edward Lakatos
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  10. Lot B. Page
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  11. H. Mitchell Perry Jr.
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  12. W. McFate Smith
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Editor information

Editors and Affiliations

  1. National Cardiovascular Center Hospital, Suita, Osaka, 565, Japan

    Teruo Omae (Director of Hospital) (Director of Hospital)

  2. Centro di Fisiologia Clinica e Ipertensione, Ospedale Maggiore di Milano, Instituto di Clinica Medica IV, Università di Milano, 20122, Milan, Italy

    Alberto Zanchetti (Professor) (Professor)

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© 1989 Springer Japan

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Probstfield, J.L. et al. (1989). The Systolic Hypertension in the Elderly Program (SHEP): Rationale, Design, Recruitment, and Baseline Data. In: Omae, T., Zanchetti, A. (eds) How Should Elderly Hypertensive Patients Be Treated?. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68340-7_11

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  • DOI: https://doi.org/10.1007/978-4-431-68340-7_11

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68342-1

  • Online ISBN: 978-4-431-68340-7

  • eBook Packages: Springer Book Archive

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