Results of antihypertensive treatment trials in the elderly.
The prevalence of arterial hypertension is age-dependent, and with the prolongation of life expectancy the number of elderly subjects with arterial hypertension is very relevant. Epidemiologic studies have shown that arterial hypertension is a risk factor in elderly patients and therefore the physician must know if the pharmacologic and nonpharmacologic reduction of blood pressure values is associated with a corresponding decrease in systolic-diastolic or isolated systolic hypertension. Clinical trials have shown that the lowering of blood pressure values is commonly associated with a decrease in cardiovascular events. So far, the reduction of blood pressure per se appears more relevant to the cardiovascular benefit than does a particular class of antihypertensive agents. The benefit of antihypertensive treatment has been shown up to the age of 80 years, while there are no clear indications of a benefit in persons older than 80 years. While sufficient data suggest that a diastolic blood pressure between 80 and 90 mm Hg is associated with a clear benefit in elderly patients, the data in support of a systolic reduction below 140 mm Hg require further direct confirmation.
Leonetti
Gastone
G
Istituto Auxologico Italiano, Istituto Scientifico San Luca, Ospedale Maggiore, Universita di Milano, Via Spagnoletto 3, 20149 Milan, Italy. gastone.leonetti@unimi.it
Zanchetti
Alberto
A
D000328:Adult; D000367:Age Factors; D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002681:China / Q000453:epidemiology; D002986:Clinical Trials as Topic / Q000639:trends; D005060:Europe / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D015995:Prevalence
D000959:Antihypertensive Agents; D009543:Nifedipine