Key result
Antihypertensive treatment cuts stroke risk ~33% vs placebo in elderly hypertensive patients.
Why the study?
Does antihypertensive treatment reduce the incidence of stroke and cognitive decline in elderly hypertensive patients?
Meta-Analysis
Does antihypertensive treatment reduce the incidence of stroke and cognitive decline in elderly hypertensive patients?
Effect estimate: RR 0.67 (95% CI 0.57-0.79)
Antihypertensive therapy in elderly patients significantly reduces the risk of stroke, though its impact on cognitive decline and dementia remains unclear due to short trial follow-ups.
Reinforces antihypertensive therapy for stroke prevention in elderly hypertensives; leaves cognitive effects unresolved pending longer follow-up.
AIM: To evaluate the effectiveness of antihypertensives in reducing neurocognitive outcomes in elderly patients. PATIENTS & METHODS: We conducted a systematic literature search of randomized trials in which hypertensive patients with a mean age ≥65 years received antihypertensive or control treatment. Outcomes were stroke, transient ischemic attack, cognitive decline and dementia. We included 14 trials for meta-analysis. RESULTS: Compared to placebo, antihypertensive treatment reduced the risk of stroke (RR: 0.67 [95% CI: 0.57-0.79]). Reduced risk was significant for transient ischemic attack, fatal stroke, nonfatal stroke and total stroke. There were insufficient data to compare individual agents. CONCLUSION: Antihypertensive treatment is associated with a significant reduction in stroke in elderly individuals. Reductions in dementia and cognitive decline were not significant; however, there was short follow-up. Comparative effectiveness evidence is limited.
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Parsons et al. (2016) conducted a meta-analysis in Hypertension. Antihypertensive treatment vs. Placebo or control treatment was evaluated on Stroke (RR 0.67, 95% CI 0.57-0.79). Antihypertensive treatment significantly reduced the risk of stroke compared to placebo in elderly hypertensive patients (RR 0.67; 95% CI 0.57-0.79).
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