A new study presented by Poland’s Dr Maciej Ostrowski at ESC Congress 2014 has found that the treating hypertensive older adults with antihypertensive therapy reduces the risk of cardiovascular (CV) events, strokes and mortality.
Dr Ostrowski said: “Over the past few decades, a number of randomised trials and meta‑analyses have supported the benefits of antihypertensive medication in reducing the incidence of cardiovascular disease (CVD) among hypertensive patients over the age of 65 years. However, these studies were not designed to identify the appropriate target blood pressure (BP) in this population.”
He added: “There is also still a large debate on the optimal target BP level for older adults with hypertension, especially concerning whether systolic BP reduction below 140 mmHg is beneficial and safe. Experts have emphasised that very limited data exist to make definitive recommendations on how low we should reduce BP in older patients, and that data are lacking on the effects of hypertensive therapy in this group of patients.”The aim of the current meta-analysis was to investigate the effect of hypertension therapy on BP, and CV and mortality outcomes in patients over the age of 65 years. The safetyofBP lowering inolder adults was also analysed. The study was performed within theLipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group
The researchers looked at data published during 1966 to 2013 on Scopus, PubMed, Web of Science, and the Cochrane Central Register of randomised controlled trials (RCTs) for appropriate studies. They included 11 RCTs with 40 325 hypertensive older patientsrandomised to receive either antihypertensive drugs or placebo.
They found that BP lowering therapy was associated with a significant reduction in systolic BP (-12.43 mmHg,95% confidence interval [CI]: -21.07 to -3.79;p=0.005) and diastolic BP (-5.06 mmHg,95%CI: -9.21 to -0.92;p=0.02).
It was also associated with a significant reduction in all-cause mortality rate by 13% (relative risk [RR] 0.87,95%CI: 0.81-0.93;p
There was no significant relation between BP lowering in older adults and the risk ofhospitalisations due to angina pectoris (RR 1.13, 95%CI: 0.9-1.41;p>0.05) or heart failure (0.95, 95%CI: 0.76-1.18;p>0.05). However an association between BP lowering and the riskof falls was observed (1.21, 95%CI: 1.05-1.44; p