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To the Editor: The Clinical Review on systolic hypertension in older persons by Dr Chaudhry and colleagues¹ concluded that the evidence for treating patients with systolic blood pressure (SBP) in the range of 140 to 159 mm Hg is "less strong" than that for patients with SBP of 160 mm Hg and higher. In part, this conclusion was based on the entry criteria and baseline blood pressures of patients in the Systolic Hypertension in Elderly Persons (SHEP) trial.² However, a close look at the data from this trial suggests a very different interpretation.

To be eligible for SHEP, patients had to have an SBP of 160 to 219 mm Hg at the time of baseline examination; the mean SBP at baseline was approximately 170 mm Hg in both groups. However, at the 1-year examination mean SBP in the placebo group had decreased to 156.5 mm Hg, and mean SBP remained . . . [Full Text of this Article]

David W. Baker, MD
dbaker1@nmff.org
Department of Medicine
Northwestern University Feinberg School of Medicine
Chicago, Ill

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