Stroke Prevention by Antihypertensive Drugs (SPREAD) Trial

Inclusion criteria: Hypertensive patients, including untreated hypertensive patients (systolic/diastolic blood pressure >=140/90mmHg at two visits), and treated hypertensive patients (systolic/diastolic blood pressure >=140/90mmHg at two visits). Exclusion criteria: Secondary hypertension; controindications to any study drugs; serum potassium values<3.5mEq/L or >5.5mEq/L at screening stage; requirement for any study drugs for reasons other than hypertension; low likelihood of compliance with protocol (eg, dementia, substance abuse); and a history of any severe, life‐threatening disease within the past 3 years. Hypertension 1) Hydrochlorothiazide (single tablet orally taken twice daily, 12.5 or 25 milligrams) based combinations with Atenolol (single tablet, orally, 12.5 or 25 milligrams, twice daily); 2) Nifedipine Sustained Release (single tablet, orally taken, 20 or 40 milligrams, twice daily) based combinations with Captopril (single tablet, orally, 25 or 50 milligrams, twice daily); Check the compliance for antihypertensive drugs once a month. All interventions were for two years. Patients were first treated with lower dosage; if their blood pressure was still above 140/90 mmHg after two weeks, the dosage was increased to the second higher dosage; if their blood pressure was still above 140/90 mmHg after four weeks, Hydrochlorothiazide based group combined with Atenolol while the Nifedipine Sustained Release based group combined with Captopril. Cardiovascular events including all causes of death, myocardial infarction, stroke, and heart faiture;Metabolic alternations;New onset diabetes;Target organ damage: left ventricular hypertrophy (LVH), renal dysfunction (serum creatinine level, microalbuminuria);Office blood pressure response from baseline to 2 years Office blood pressure response