Age-related effects of placebo and active treatment in patients beyond the age of 60 years: the need for a proper control group.
The age-related response to placebo and active antihypertensive treatment was evaluated in 742 elderly hypertensive patients who were followed in the double-blind placebo-controlled trial conducted by the European Working Party on High blood pressure in the Elderly (EWPHE). In the two treatment groups, the fall in systolic and diastolic blood pressures after 3 months was negatively correlated with age (P less than 0.02), indicating that the hypotensive effect of placebo and active treatment was more pronounced in older patients. Further comparison of the two treatment groups failed to demonstrate any statistical differences in the slopes of the hypotensive effect on age. These conclusions were not altered by cumulative adjustments for baseline blood pressure, pulse rate, serum creatinine and the presence of cardiovascular complications at entry. In conclusion, in the present study, a similar blood-pressure-lowering action which increased with age was observed on active and placebo treatment; thus, proof that an observed age-related hypotensive effect is caused by a particular drug requires comparison with a control group on placebo.
Thijs
L
L
Klinisch Laboratorium Hypertensie, Inwendige Geneeskunde-Cardiologie, Leuven, Belgium.
Amery
A
A
Birkenhäger
W
W
Bulpitt
C J
CJ
Clement
D
D
de Leeuw
P
P
De Schaepdryver
A
A
Dollery
C
C
Forette
F
F
Henry
J F
JF
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001581:Benzothiadiazines; D001794:Blood Pressure / Q000502:physiology; D004232:Diuretics; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010919:Placebos; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use*
D001581:Benzothiadiazines; D004232:Diuretics; D010919:Placebos; D049993:Sodium Chloride Symporter Inhibitors