Why the study?
Does antihypertensive treatment to a goal blood pressure of <150/80 mmHg reduce mortality and cardiovascular events in the very elderly?
Does antihypertensive treatment to a goal blood pressure of <150/80 mmHg reduce mortality and cardiovascular events in the very elderly?
Hazard Ratio: 0.79
p-value: p=0.02
Antihypertensive treatment targeting a BP <150/80 mmHg in the very elderly reduces mortality and cardiovascular events without increasing risks of adverse geriatric outcomes.
May support <150/80 mmHg target in very elderly without added harms; leaves open dedicated RCTs.
Although the number of individuals reaching 80 who are considered to be healthy is increasing, the very elderly are likely to have long-term conditions, to report symptoms and/or be taking at least one regular medication. The impact of antihypertensive treatment has to be taken into account in this context. The treatment regimen in Hypertension in the Very Elderly Trial with a goal blood pressure of <150/80 mmHg has been shown to provide benefits in terms of a reduction in risk of total mortality, stroke, and cardiovascular events with potential benefits and no evidence of increased risk for fracture, dementia, depression, and quality-of-life outcomes. Questions remain as to the level of benefit that would be accrued in the frailer elderly and those at extreme age, for example, over 90.
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Peters et al. (2013) conducted a review in Hypertension (n=3,845). Indapamide sustained release with optional perindopril vs. Placebo was evaluated on Total mortality (HR 0.79, 95% CI 0.65-0.95, p=0.02).
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