Key result
Morning home systolic blood pressure ≥155 mmHg was associated with a significantly higher risk of major cardiovascular events compared with <125 mmHg, regardless of age.
Why the study?
Does achieved morning home systolic blood pressure correlate with cardiovascular risk similarly in hypertensive patients aged ≥75 years compared to those <75 years?
Observational (n=21,591)
Does achieved morning home systolic blood pressure correlate with cardiovascular risk similarly in hypertensive patients aged ≥75 years compared to those <75 years?
Targeting similar morning home systolic blood pressure levels in very elderly (≥75 years) and younger patients may be beneficial in reducing cardiovascular risk, provided the treatment is tolerated.
Association between high morning home SBP and CV events holds across ages; leaves open optimal targets for elderly hypertensives.
The appropriate target blood pressure (BP) in elderly patients with hypertension remains uncertain. We investigated the relationship between morning home systolic blood pressure (MHSBP) during follow-up and cardiovascular (CV) risk in outpatients receiving olmesartan-based treatment aged <75 years (n = 16799) and ≥75 years (n = 4792) in the HONEST study. In the follow-up period (mean 2.02 years), the risk for major CV events was significantly higher in patients with MHSBP ≥155 mmHg compared with <125 mmHg in both age groups in Cox proportional hazards model adjusted for other risk factors and there was no significant difference in trend between the two groups (interaction P = 0.9917 for MHSBP). Hazard ratios for CV events for 1-mmHg increase in MHSBP were similar in patients aged <75 years and in patients aged ≥75 years. The incidence of adverse drug reactions related to excessive BP lowering was lower in patients <75 years than in patients ≥75 years (0.73 vs 1.02%, P = 0.0461). In conclusion, the study suggests even in patients ≥75 years antihypertensive treatment targeting the same MHSBP levels in patients <75 years may be beneficial in reducing CV risk when treatment is tolerated.
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Saito et al. (2018) conducted an observational in hypertension (n=21,591). Morning home systolic blood pressure (MHSBP) ≥155 mmHg vs. MHSBP <125 mmHg was evaluated on major cardiovascular events. Morning home systolic blood pressure ≥155 mmHg was associated with a significantly higher risk of major cardiovascular events compared with <125 mmHg, regardless of age.
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