Systolic Hypertension in the Elderly Program (SHEP) (Pilot Study)

Overview[ - collapse ][ - ]

Purpose The SHEP Pilot Study had six objectives, each designed to develop and test critical components of a full scale trial directed at the health consequences of treating isolated systolic hypertension (ISH) in the elderly. l. To estimate and compare the yield of participants for randomization into a clinical trial from various community groups using various recruitment techniques. 2. To estimate compliance with the visit schedule and to the prescribed double-blind regimens. 3. To estimate and compare the effectiveness of specified antihypertensive medications in reducing the blood pressure. 4. To estimate and compare the unwanted effects of specified antihypertensive medication in an elderly population. 5. To evaluate the feasibility and effectiveness of periodic behavioral assessment in this population. 6. To develop and test methods of ascertaining stroke and other disease endpoints.
ConditionCardiovascular Diseases
Heart Diseases
Hypertension
Vascular Diseases
InterventionDrug: chlorthalidone
Drug: reserpine
Drug: hydralazine
Drug: metoprolol
PhasePhase 2
SponsorNational Heart, Lung, and Blood Institute (NHLBI)
Responsible PartyNational Heart, Lung, and Blood Institute (NHLBI)
ClinicalTrials.gov IdentifierNCT00000499
First ReceivedOctober 27, 1999
Last UpdatedNovember 25, 2013
Last verifiedApril 2012

Tracking Information[ + expand ][ + ]

First Received DateOctober 27, 1999
Last Updated DateNovember 25, 2013
Start DateSeptember 1980
Estimated Primary Completion DateMay 1983
Current Primary Outcome MeasuresNot Provided
Current Secondary Outcome MeasuresNot Provided

Descriptive Information[ + expand ][ + ]

Brief TitleSystolic Hypertension in the Elderly Program (SHEP) (Pilot Study)
Official TitleNot Provided
Brief Summary
The SHEP Pilot Study had six objectives, each designed to develop and test critical
components of a full scale trial directed at the health consequences of treating isolated
systolic hypertension (ISH) in the elderly.

l. To estimate and compare the yield of participants for randomization into a clinical
trial from various community groups using various recruitment techniques.

2. To estimate compliance with the visit schedule and to the prescribed double-blind
regimens.

3. To estimate and compare the effectiveness of specified antihypertensive medications in
reducing the blood pressure.

4. To estimate and compare the unwanted effects of specified antihypertensive medication in
an elderly population.

5. To evaluate the feasibility and effectiveness of periodic behavioral assessment in this
population.

6. To develop and test methods of ascertaining stroke and other disease endpoints.
Detailed Description
BACKGROUND:

Isolated systolic hypertension, defined as systolic blood pressure of 140 mm Hg or greater
with a diastolic blood pressure below 90 mm Hg, is known to be associated with an increase
of risk of coronary heart disease and stroke. The HANES I group estimated that isolated
systolic hypertension, uncommon under 54 years of age, occurred in 5 percent to 10 percent
of adults over 55 years and was less common than systolic-diastolic elevation. Evidence was
not readily available that there was effective and safe therapy to correct isolated systolic
hypertension. At that time, there was no body of clinical or research data that
conclusively proved that such therapy, if available, was beneficial.

Several groups had expressed interest in a clinical trial on systolic hypertension in the
elderly. Among these were the House Select Committee on Aging, a Blue-Ribbon Panel on
Hypertension in the Elderly, Citizens for the Treatment of High Blood Pressure, panels and
experts associated with the National High Blood Pressure Education Program, the National
Institute on Aging, the National Institute of Mental Health, and the National Institute of
Neurological and Communicative Disorders and Stroke.

A Policy and Data Monitoring Board was appointed to review the protocols for the pilot
studies as they developed and make recommendations to the Director of NHLBI. The Policy and
Data Monitoring Board reviewed the accumulated data on April 8, 1983 and recommended to the
Institute that a full scale trial be implemented. The recommendation was accepted by the
Director, NHLBI and was presented to the National Heart, Lung, and Blood Advisory Council at
its meeting in May 1983. A full scale trial was conducted.

DESIGN NARRATIVE:

A randomized, double-blind design, with two groups and fixed sample size. The 551
participants were randomized in a stratified double-blind manner to either chlorthalidone or
matching placebo in a ratio of 4:l. Subjects failing to reach goal blood pressure were
randomized a second time to receive one of the following drugs in addition to
chlorthalidone: reserpine, hydralazine, and metoprolol. Subjects on placebo in Step I who
did not achieve goal had a corresponding Step II placebo added to their regimen.
Study TypeInterventional
Study PhasePhase 2
Study DesignAllocation: Randomized, Masking: Double-Blind, Primary Purpose: Treatment
Condition
  • Cardiovascular Diseases
  • Heart Diseases
  • Hypertension
  • Vascular Diseases
InterventionDrug: chlorthalidone
Drug: reserpine
Drug: hydralazine
Drug: metoprolol
Study Arm (s)Not Provided

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated EnrollmentNot Provided
Estimated Completion DateMay 1983
Estimated Primary Completion DateNot Provided
Eligibility Criteria
Men and women, aged 60 or over. Isolated systolic hypertension. Normal diastolic pressure
of less than 90 mm Hg.
GenderBoth
Ages60 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesNot Provided

Administrative Information[ + expand ][ + ]

NCT Number NCT00000499
Other Study ID Numbers18
Has Data Monitoring CommitteeNot Provided
Information Provided ByNational Heart, Lung, and Blood Institute (NHLBI)
Study SponsorNational Heart, Lung, and Blood Institute (NHLBI)
CollaboratorsNational Institute on Aging (NIA)
Investigators Merwyn Greenlick Kaiser Foundation Research Institute Robert McDonald University of Pittsburgh H. Perry Washington University Harold Schnaper University of Alabama at Birmingham James Schoenberger Rush University
Verification DateApril 2012