ORIGINAL CONTRIBUTION Effect of Treating Isolated Systolic Hypertension on the Risk of Developing

THE SYSTOLIC HYPERTENSION INthe Elderly Program (SHEP)was the first completed trialinvestigating isolated systolic hypertension. Results showed that treatment of hypertension reduced all strokes, both fatal and nonfatal, by 36%; all myocardial infarctions (MIs), both fatal and nonfatal, by 27%; all coronary heart disease by 27%; and all cardiovascular disease by 32%. Total mortality was reduced by 13%. Reductions were also demonstrated in the number of transient ischemic attacks (TIAs), and episodes of con-gestive heart failure.1 This article examines, for the first time to our knowledge, the distribu-tion of stroke types (ischemic or hem-orrhagic) and their various subtypes in active treatment vs placebo group participants. It also examines the tim-ing of strokes, the number that were fatal, their relationship to attained systolic blood pressure (SBP), and their residual effects. Author Affiliations are listed at the end of this article