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Summary
Seven hundred and ninety-two hypertensive patients above the age of 60 years have entered the double-blind multicentre trial of the European Working Party on High Blood Pressure in the Elderly (EWPHE). Half were treated with I capsule daily containing 2.5 mg hydrochlorothiazide and 50 mg triamterene and half were given placebo. If blood pressure control was not adequate in those receiving active treatment, a second capsule was given and, if necessary, up to 2 g methyl-dopa/day. No significant differences between the groups were present prior to randomization. A significant blood pressure difference of 20/8 mmHg was obtained between the groups and maintained during 5 years of follow-up. No major disturbances in serum potassium or serum sodium were noted. On the other hand. during the initial phase an increase in serum creatinine and serum uric acid was noted in the actively-treated group which was maintained during the later years. This increase in serum creatinine was related to the decrease in sitting systolic blood pressure. Also, changes in serum uric acid correlated with changes in serum creatinine both in the placebo and in the actively-treated group; the serum uric acid was on average I mg higher in the actively-treated than in the placebo-group. Fasting blood glucose did not change significantly in the placebo-treated group, but it did so in the active-treatment group. A favourable influence of active treatment on prognosis can be expected on the basis of the blood pressure reduction and in the absence of major electrolyte disturbances. However, the balance between this decreased risk and the increase produced by the rise in blood glucose and the other treatment effects remains to be determined. The trial continues and more patients are being admitted.