This trial was design to address the uncertainty around the cardiovascular benefits of newer antihypertensive medications (ACE inhibitors and CCBs) with older medications (diuretics and beta blockers). This trial enrolled 6614 patients 70-84 years old with BP at least 180/105mmHg. Patients were randomly assigned to conventional drugs (atenolol, metoprolol, pindolol, or HCTZ plus amiloride) or to newer drugs (enalapril, lisinopril, felodipine, or isradipine). The primary endpoint was a combined endpoint of fatal stroke fatal MI, and other fatal CV disease. There was no difference in the primary outcome of the new drugs and older drugs. Limitations to this trial include the fact that it was open-label. This could have influenced the assessment of some cardiovascular events which rely on the presence of signs and symptoms. In addition, there was considerable cross-over in the trial -- only 61-66% of patients were still on their originally-intended randomized medications at the end of the trial.
The STOP-2 Trial: Lindholm, L. H., Hansson, L., Dahlouf, B., Ekbom, T., Hedner, T., De Faire, U., ... & Wester, P. O. (1996). The Swedish Trial in old patients with hypertension-2 (STOP-hypertension-2): a progress report. Blood pressure, 5(5), 300-304.
The STOP-2 Trial PMID: 8879603
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