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The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial
Lithell H, Hansson L, Skoog I, Elmfeldt D, Hofman A, Olofsson B, Trenkwalder P, Zanchetti A et al.. Journal of hypertension, 2003-05-01
Topic: Risk, prevention and care in population studies
Results Blood pressure fell by 21.7/10.8 mmHg in the candesartan group and by 18.5/9.2 mmHg in the control group. There were no significant differences in myocardial infarction and cardiovascular mortality. The proportions of patients who had a significant cognitive decline or developed dementia were not different in the two treatment groups. Conclusions In elderly hypertensive patients, a slightly more effective blood pressure reduction during candesartan-based therapy, compared with control therapy, was associated with a modest, statistically non-significant, reduction in major cardiovascular events and with a marked reduction in non-fatal stroke.
Key findings
- Results Blood pressure fell by 21.7/10.8 mmHg in the candesartan group and by 18.5/9.2 mmHg in the control group.
- There were no significant differences in myocardial infarction and cardiovascular mortality.
- The proportions of patients who had a significant cognitive decline or developed dementia were not different in the two treatment groups.
- Conclusions In elderly hypertensive patients, a slightly more effective blood pressure reduction during candesartan-based therapy, compared with control therapy, was associated with a modest, statistically non-significant, reduction in major cardiovascular events and with a marked reduction in non-fatal stroke.
Why it matters
In this trial of elderly hypertensive patients, blood pressure reduction with candesartan-based therapy did not significantly reduce the proportion of patients who had significant cognitive decline or developed dementia. There was a marked reduction in non-fatal stroke, but no significant difference in cognitive outcomes between treatment groups.
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Study details
- Study designopen-label trial
- Participants4,964
- Effect size10.9%; 27.8%; 23.6%
- Evidence strengthHigh
How this study scored 68/100
Published in a peer-reviewed journal. Scored zero for study design because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of hypertension) |
| Journal's citation record | 2 / 4 | Journal of Hypertension: journal h-index 236 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | Design recorded as “open-label trial”, which our rubric does not rank (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 3 / 4 | 4,964 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | 7 / 7 | Cited 1,412 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 56.5 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 6 / 6 | Cited 78.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 35 other studies in this library |
| Still being cited | 2 / 4 | Cited 38 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Alberto Zanchetti: h-index 119 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Erasmus MC: institution h-index 1,321 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 9 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12714861) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 68 / 100 | — |
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Read the original
May need a subscription Unpaywall, Europe PMC and OpenAlex found no free copy of the full text (checked 10 Oct 2026), so the publisher may charge for it. The PubMed abstract is free.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Lithell, H., Hansson, L., Skoog, I., Elmfeldt, D., Hofman, A., Olofsson, B., et al. (2003). The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. Journal of hypertension. https://doi.org/10.1097/00004872-200305000-00011
Vancouver
Lithell H, Hansson L, Skoog I, Elmfeldt D, Hofman A, Olofsson B, et al. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. Journal of hypertension. 2003. doi:10.1097/00004872-200305000-00011. PMID: 12714861.
BibTeX
@article{lithell2003-12714861,
author = {Lithell, H. and Hansson, L. and Skoog, I. and Elmfeldt, D. and Hofman, A. and Olofsson, B. and Trenkwalder, P. and Zanchetti, A. and others},
title = {{The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial}},
journal = {Journal of hypertension},
year = {2003},
doi = {10.1097/00004872-200305000-00011},
pmid = {12714861},
url = {https://doi.org/10.1097/00004872-200305000-00011}
}
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