title: Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials.
abstract: OBJECTIVE
  To quantify the relative risk reductions achieved with different regimens to lower blood pressure in younger and older adults.
  
  
  METHODS
  Meta-analyses and meta-regression analyses used to compare the effects on the primary outcome between two age groups (<65 v > or =65 years). Evidence for an interaction between age and the effects of treatment sought by fitting age as a continuous variable and estimating overall effects across trials.
  
  
  METHODS
  
  
  
  METHODS
  total major cardiovascular events.
  
  
  RESULTS
  31 trials, with 190 606 participants, were included. The meta-analyses showed no clear difference between age groups in the effects of lowering blood pressure or any difference between the effects of the drug classes on major cardiovascular events (all P> or =0.24). Neither was there any significant interaction between age and treatment when age was fitted as a continuous variable (all P>0.09). The meta-regressions also showed no difference in effects between the two age groups for the outcome of major cardiovascular events (<65 v > or =65; P=0.38).
  
  
  CONCLUSIONS
  Reduction of blood pressure produces benefits in younger (<65 years) and older (> or =65 years) adults, with no strong evidence that protection against major vascular events afforded by different drug classes varies substantially with age.
authors.affiliation: George Institute for International Health, University of Sydney, PO Box M201, Sydney, NSW 2050, Australia. fturnbull@george.org.au
authors.forename: F
authors.initials: F
authors.lastname: Turnbull
authors.forename: B
authors.initials: B
authors.lastname: Neal
authors.forename: T
authors.initials: T
authors.lastname: Ninomiya
authors.forename: C
authors.initials: C
authors.lastname: Algert
authors.forename: H
authors.initials: H
authors.lastname: Arima
authors.forename: F
authors.initials: F
authors.lastname: Barzi
authors.forename: C
authors.initials: C
authors.lastname: Bulpitt
authors.forename: J
authors.initials: J
authors.lastname: Chalmers
authors.forename: R
authors.initials: R
authors.lastname: Fagard
authors.forename: A
authors.initials: A
authors.lastname: Gleason
authors.forename: S
authors.initials: S
authors.lastname: Heritier
authors.forename: N
authors.initials: N
authors.lastname: Li
authors.forename: V
authors.initials: V
authors.lastname: Perkovic
authors.forename: M
authors.initials: M
authors.lastname: Woodward
authors.forename: S
authors.initials: S
authors.lastname: MacMahon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000401:mortality*; D040261:Harm Reduction; D006331:Heart Diseases / Q000209:etiology / Q000401:mortality*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents