19th Congress of the European Society of Cardiology

Drug Reduces Risk of Stroke for Hypertensive Patients


STOCKHOLM, SWEDEN -- Calcium channel blockers can play an important role in preventing stroke and cardiovascular (CV) events in elderly people with isolated systolic hypertension, reports a major European study. Isolated systolic hypertension reportedly affects one person in 20 at the age of 60, and one in four at the age of 80.

The SYST-EUR trial, presented at the 19th Congress of the European Society of Cardiology held here on August 25-30, examined the use of nitrendipine, a dihydropyradine calcium channel blocker, in 4,695 elderly patients in 23 European countries.

Patients enrolled in the trial were all 60 years of age or more, and three-quarters of them had systolic blood pressure between 160 and 179mmHg. Two-thirds of the participants were female, and 30 percent of those had other CV complications including prior myocardial infarction (MI), heart disease and left ventricular hypertrophy.

The study was stopped when 100 strokes were recorded, because stroke was the end-point for the study, explained Dr. Robert Fagard, a professor in the Hypertension Unit at the University of Leuven, in Belgium.

In all, there was a 42 percent reduction in the incidence of stroke in the study, a trend which began to show up quite early in the study, he said. At the same time, cardiac end-points such as sudden death, MI and heart failure were reduced by 26 percent overall. Deaths from CV disease alone were reduced by 27 percent.

An interesting and important revelation to emerge from the trial was that there was no increase in cancer deaths or new cases of cancer resulting from patients using calcium channel blockers, said Dr. Fagard. "We looked at this specifically because of the cancer controversy," he explained, noting that in recent years, there have been reports of an association between calcium channel blockers and an increased risk of cancer and some internal bleeding.

In fact, the study showed 15 percent fewer new cases of cancer in the study group than in the control group. A figure which, although important, was not considered statistically significant.

"We can conclude that step-wise, antihypertensive treatment starting with dihydropyridine calcium channel blockers reduces the incidence of stoke and CV complications in elderly patients with isolated systolic hypertension and that treating 1,000 patients for five years would prevent 26 strokes and 53 major cardiovascular complications," he said.