Antihypertensive Treatment in the Elderly: Is Lower Always Better?
Author Information
Author(s): Mazza Alberto, Ramazzina Emilio, Cuppini Stefano, Armigliato Michela, Schiavon Laura, Rossetti Ciro, Marzolo Marco, Santoro Giancarlo, Ravenni Roberta, Zuin Marco, Zorzan Sara, Rubello Domenico, Casiglia Edoardo
Primary Institution: Santa Maria della Misericordia Hospital
Hypothesis
Does the paradigm 'the lower, the better' maintain a prognostic role in elderly and very old hypertensives?
Conclusion
Antihypertensive treatment is justified in elderly patients, but overly aggressive blood pressure targets may not provide additional benefits and could be harmful.
Supporting Evidence
- Over 80% of elderly individuals have hypertension, primarily isolated systolic hypertension.
- Antihypertensive treatment has shown benefits in reducing stroke and cardiovascular events in elderly patients.
- Clinical trials indicate that the absolute benefit of treatment is higher in elderly patients due to their baseline cardiovascular risk.
- Some studies suggest that overly aggressive blood pressure targets may not yield additional benefits and could be harmful.
Takeaway
This study looks at how lowering blood pressure affects older people. It finds that while lowering blood pressure is important, making it too low can actually be bad for them.
Methodology
The study reviews clinical trials and meta-analyses regarding antihypertensive treatment in elderly populations.
Potential Biases
The trials often did not include a diverse representation of elderly patients, particularly those with comorbidities.
Limitations
Most trials included participants under 80 years old, which may not represent the very elderly population accurately.
Participant Demographics
Elderly individuals, particularly those aged 65 and older, with a focus on those aged 80 and above.
Digital Object Identifier (DOI)
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