Antihypertensive Therapy in Patients Above Age 60: A report of the European Working Party on High Blood Pressure in the Elderly (EWPHE)

Amery, A; Wh, Birkenhäger; Bogaert, M. G.; Brixko, P; Bulpitt, Christopher J.; Clement, D; Leeuw, Peter de; Plaen, J. F. De; Deruyttere, M; Schaepdryver, André De; Fagard, Robert; Forette, Françoise; Forte, J; Hamdy, R; Hellemans, J.; Henry, J. F.; Koistinen, A; Leonetti, Gastone; Lewis, Paul; Lund‐Johansen, Per; Macfarlane, John; Meurer, K. A.; Miguel, Patricia Martínez; Morris, John R.; Mutsers, A; Nissinen, Anne; O’Brien, Ellen; O’Malley, K; Omvik, Per; Petrie, J C; Terzoli, L.; Tuomilehto, J; Williams, Brian H.; Willemse, Pierre J.

doi:10.1007/978-1-4757-1824-9_20

Cited by 7 publications

(8 citation statements)

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“…The fall in serum potassium in the trial averaged only 0.2 mmol/l (Amery & de Schaepdryver, 1981) and it is possible that a larger decrease in serum potassium would have led to a more serious deterioration in glucose tolerance than that observed in the trial. In the Medical Research Council Trial on mild hypertension (1981) the fall in serum potassium in comparison to placebo averaged 0.6 mmol/l when only a potassium losing diuretic was employed.…”

Section: Discussionmentioning

confidence: 74%

Glucose intolerance during diuretic therapy in elderly hypertensive patients. A second report from the European Working Party on high blood pressure in the elderly (EWPHE)

Améry¹,

Wh²,

Brixko³

et al. 1986

Postgraduate Medical Journal

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Summary:Five hundred and seven elderly hypertensive patients were followed for 1 year, 371 for 2 years and 270 for 3 years in a double-blind, randomized, controlled trial in which they received either placebo or 25-50mg hydrochlorothiazide and 50-100mg of triamterene daily. One third of the active treatment group also received 250 mg to 2 g methyldopa daily. After 1 year the active treatment group had an average increase in fasting blood sugar of 2.5 mg/dl compared with an average fail of 1.4 mg/dl in the placebo group (P = 0.01). The increase "M blood sugar 1 hour and 2 hours after 50 g oral glucose tended to be greater in the actively treated group but these increases did not achieve statistical significance. The effects of diuretic treatment were established after one year and did not increase further over the next 2 years. Overall there was an increase in fasting blood sugar of 5 mg/dl in the active treatment group which occurred mainly in the first year.The hyperglycaemic effect ofdiuretics appeared to be partly or wholly related to potassium loss since, in both groups, impairment of glucose tolerance was most marked in those in whom serum potassium decreased. The measures of blood sugar were also positively related to systolic pressure before and after treatment.The following centres collaborate in the EWPHE trial:

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Section: Discussionmentioning

confidence: 74%

Glucose intolerance during diuretic therapy in elderly hypertensive patients. A second report from the European Working Party on high blood pressure in the elderly (EWPHE)

Améry¹,

Wh²,

Brixko³

et al. 1986

Postgraduate Medical Journal

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“…47 Renal parenchymal disease was considered the cause of elevated blood pressure in 8% of EWPWE subjects with systolic hypertension. 48 In the HDFP population, which included patients with known glomerulonephritis, 21 4% had у2+ proteinuria, 5% had hematuria and 7% pyuria. 49 It is generally accepted that blood pressure reduction slows renal function deterioration in patients with established renal parenchymal disease or decreased glomerular filtration rate.…”

Section: Discussionmentioning

confidence: 99%

Does treatment of non-malignant hypertension reduce the incidence of renal dysfunction? A meta-analysis of 10 randomised, controlled trials

Hsu

2001

J Hum Hypertens

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Objective: It remains controversial whether non-malignant 'benign' hypertension causes renal dysfunction. The effect of lowering blood pressure on the incidence of renal dysfunction among patients with non-malignant hypertension is not clear. This meta-analysis was conducted to determine whether antihypertensive drug therapy reduces the incidence of renal dysfunction in patients with non-malignant hypertension. Methods: Randomised, controlled trials of antihypertensive drug therapy of more than 1 year duration that reported renal dysfunction as an outcome were identified through MEDLINE search and literature review. A random effects model was used to obtain summary estimates. Results: Ten trials were identified, involving 26 521 individuals and 114 000 person-years. All excluded subjects with advanced baseline renal disease. Definition of renal

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“…However, the demonstration that patients in this age group do benefit from long term treatment of their systolic hypertension is still missing. One epidemiological study currently in progress (Amery et al, 1978) should hopefully answer this question.…”

Section: Introductionmentioning

confidence: 99%

“…Diuretics, although effective in elderly patients, can cause an increase in their plasma creatinine concentration (Amery et al, 1978). Centrally acting antihypertensive drugs could favour postural hypotension in the elderly, particularly those with cerebrovascular disease (Appenzeler & Descarries, 1974).…”

Section: Introductionmentioning

confidence: 99%

Effect of a new calcium antagonist, tiapamil, in hypertension of the elderly.

Balansard¹,

Elkik²,

Ja³

et al. 1984

Brit J Clinical Pharma

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Antihypertensive Therapy in Patients Above Age 60: A report of the European Working Party on High Blood Pressure in the Elderly (EWPHE)

Cited by 7 publications

References 0 publications

Glucose intolerance during diuretic therapy in elderly hypertensive patients. A second report from the European Working Party on high blood pressure in the elderly (EWPHE)

Glucose intolerance during diuretic therapy in elderly hypertensive patients. A second report from the European Working Party on high blood pressure in the elderly (EWPHE)

Does treatment of non-malignant hypertension reduce the incidence of renal dysfunction? A meta-analysis of 10 randomised, controlled trials

Effect of a new calcium antagonist, tiapamil, in hypertension of the elderly.

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