TRIAL OF NONPHARMACOLOGIC INTERVENTIONS IN THE ELDERLY

相当一部分老年人（大约30-40%）正在接受 用BP药物治疗。 老年高血压病药物治疗的疗效观察 舒张期或舒张期/收缩期联合高血压患者 但毫无疑问，这种疗法会对 生活质量和生化特征。 有一个令人信服的理由 （1）确定有多少比例的药物，控制良好的老年人 高血压患者可以维持（长期; > 30个月）， 停用BP药物后血压正常，和（2） 确定非药物治疗是否可以显著增加 取得成功的比例。 900例65-80岁SBP受试者（4个中心各225例） 将入组< 160且DBP < 90 mmHg，同时接受一种BP药物治疗的患者 在一项测试减肥和限钠效果的试验中， （单独和组合）在维持正常血压状态以下 停用抗高血压药物。 超重六百磅 参与者将被随机分配到减肥，限钠， 结合减肥和限钠，或注意力控制。 三个... 100名非超重的参与者将被随机分配到一个钠 限制或注意力控制组。 关注组将 从事一系列与BP无关的健康接触，旨在控制 群体接触的非特异性影响。 撤出 6周后将尝试抗高血压药物， 干预 主要试验终点将需要用于复发性 抗高血压药物治疗 拟议研究的意义在于 我们的研究结果可能会确定一种非药物方法， 一种安全且耐受性良好的方法，通过该方法可以停止降压治疗 约1500万65岁以上的老年人接受药物治疗， 目前正在接受BP药物治疗 此外，我们的研究将 确定老年高血压患者的比例， 血压正常状态，撤药后无任何干预 BP药物

A substantial proportion (probably 30-40%) of elderly persons are being treated with BP medications. The efficacy of BP drug therapy in older patients with diastolic or combined diastolic/systolic hypertension is well proven but there is little doubt that such therapy can adversely effect quality of life and biochemical profile. there is a compelling rationale to (1) identify what proportion of medicated, well-controlled elderly hypertensives can be maintained (long-term; > 30 months) in the normotensive state following withdrawal of BP medications, and (2) determine whether non-pharmacologic therapy can significantly increase the proportion with a successful outcome. Nine-hundred subjects (225 in each of four centers) 65-80 yrs. with a SBP < 160 and DBP < 90 mmHg while receiving one BP medication will be enrolled in a trial to test the efficacy of weight loss and sodium restriction (alone and combined) in maintaining the normotensive state following withdrawal of antihypertensive medications. Six-hundred overweight participants will be randomly assigned to weight loss, sodium restriction, combined weight loss and sodium restriction, or attention control. Three- hundred non-overweight participants will be randomly assigned to a sodium restriction or attention control group. The attention groups will be engaged in a series of non-BP related health encounters designed to control for non-specific effects of groups contacts. Withdrawal of antihypertensive medications will be attempted following 6 weeks of intervention. the primary trial endpoint will be need for recurrent antihypertensive drug therapy. The significance of the proposed study is that our findings may identify a non-pharmacologic approach which provides a safe and well-tolerated method by which to discontinue antihypertensive drug therapy in the approximately 15 million persons > 65 years who are currently being treated with BP medications. In addition, our study will identify the proportion of elderly hypertensives who can be maintained in the normotensive state without any intervention following withdrawal of their BP medications.