The purpose of the famous SHEP study conducted in the late 1980s and early 1990s

Question

The purpose of the famous SHEP study conducted in the late 1980s and early 1990s was "to assess the ability of antihypertensive drug treatment to reduce the risk of nonfatal and fatal (total) stroke in isolated systolic hypertension." Treatment with chlorthalidone was compared with placebo in 4736 patients with hypertension (SHEP, 1991). 2365 received active treatment, 2371 received placebo. The 5-year average systolic blood pressure was 155 mm Hg for the placebo group and 143 mm Hg for the active treatment group, and the 5-year average diastolic blood pressure was 72 and 68 mm Hg, respectively. The 5-year incidence of total stroke was 5.2 per 100 participants for active treatment and 8.2 per 100 for placebo. The relative risk by proportional hazards regression analysis was 0.64 (P = .0003). For the secondary end point of clinical nonfatal myocardial infarction plus coronary death, the relative risk was 0.73. Major cardiovascular events were reduced (relative risk, 0.68). For deaths from all causes, the relative risk was 0.87.

NNT to prevent one stroke is:

A. 3.3

B. 37.0

C. 33.3

D. 30

Explanation / Answer

NNT or Numbers needed to treat is defined as 1/Absolute Risk Reduction.

Absolute risk reduction for stroke prevention is given by 8.2-5.2 per 100 =3%

Hence,NTT = 1/( 3%) = 100/3 = 33.3

Hence,answer is C

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