title: The effect of antihypertensive treatment on the incidence of stroke and cognitive decline in the elderly: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the effectiveness of antihypertensives in reducing neurocognitive outcomes in elderly patients.
  
  
  METHODS
  We conducted a systematic literature search of randomized trials in which hypertensive patients with a mean age ≥65 years received antihypertensive or control treatment. Outcomes were stroke, transient ischemic attack, cognitive decline and dementia. We included 14 trials for meta-analysis.
  
  
  RESULTS
  Compared to placebo, antihypertensive treatment reduced the risk of stroke (RR: 0.67 [95% CI: 0.57-0.79]). Reduced risk was significant for transient ischemic attack, fatal stroke, nonfatal stroke and total stroke. There were insufficient data to compare individual agents.
  
  
  CONCLUSIONS
  Antihypertensive treatment is associated with a significant reduction in stroke in elderly individuals. Reductions in dementia and cognitive decline were not significant; however, there was short follow-up. Comparative effectiveness evidence is limited.
authors.affiliation: Deptartment of Internal Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Parsons
authors.affiliation: Division of Preventive Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Murad
authors.affiliation: Deptartment of Internal Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA.
authors.forename: Stuart
authors.initials: S
authors.lastname: Andersen
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
authors.forename: Farouk
authors.initials: F
authors.lastname: Mookadam
authors.affiliation: Deptartment of Internal Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA.
authors.forename: Helene
authors.initials: H
authors.lastname: Labonte
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D020521:Stroke / Q000453:epidemiology*
chemical_list: D000959:Antihypertensive Agents
keywords: aged; cognition; dementia; hypertension; stroke