Key result
Antihypertensive treatment reduces all-cause mortality ~9% vs control in hypertensive adults over 60.
Why the study?
Elevated blood pressure increases with age, but the benefits and harms of antihypertensive treatment needed quantification in adults 60 years or older, including across specific older age subgroups.
Does antihypertensive drug treatment reduce all-cause mortality and cardiovascular morbidity in adults 60 years or older with moderate to severe hypertension?
Systematic Review (n=26,795)
Yes
Does antihypertensive drug treatment reduce all-cause mortality and cardiovascular morbidity in adults 60 years or older with moderate to severe hypertension?
Antihypertensive drug therapy, primarily first-line thiazides, reduces all-cause and cardiovascular mortality in healthy adults aged 60 years or older with moderate to severe hypertension, though it increases withdrawals due to adverse effects.
Supports initiating antihypertensives in adults ≥60 with hypertension despite adverse-effect withdrawals; reinforces guideline consensus from high-certainty trial data.
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Musini et al. (2019) conducted a systematic review in hypertension (n=26,795). Antihypertensive drug treatment vs. placebo or no treatment was evaluated on all-cause mortality (RR 0.91, 95% CI 0.85 to 0.97). Antihypertensive drug treatment reduced all-cause mortality compared to placebo or no treatment in adults ≥60 years with hypertension (10.0% vs 11.0%; RR 0.91; 95% CI 0.85-0.97).
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