Should the Elderly Hypertensive Be Treated?

Davidson, Richard; Caranasos, George J.

doi:10.1001/archinte.1987.00370110061009

Cited by 16 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is no standard definition of hypertension; in a recent review of eight clinical trials of hypertension treatment in the elderly, each trial used a different definition 6 . In the current study, two alternative classifications of blood pressure were used to evaluate the incidence of hypertension.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Incidence of Hypertension in an Ambulatory Elderly Population

Davidson

Hale²,

Moore³

et al. 1989

J American Geriatrics Society

Self Cite

View full text Add to dashboard Cite

Investigations of the natural history of blood pressure have generally evaluated mean systolic and diastolic pressure changes. While information, this information is not directly applicable to clinical practice settings, in which patients are usually classified as normotensive or hypertensive. We measured the actual incidence of hypertension, using two different definitions, in an ambulatory elderly population of 2,584 individuals over an 8-year period. Using the less stringent blood pressure definition (systolic blood pressure greater than 140 mmHg and diastolic blood pressure greater than or equal to 90 mmHg), 884 (34.2%) participants were normotensive and 1,700 (65.8%) were hypertensive at an initial screening. The average annual incidence of hypertension over the subsequent eight years was 13.2%, and life tables demonstrated a gradual risk of developing hypertension. The development of hypertension was not associated with gender or age; while older age groups had a greater chance of developing hypertension than younger, the difference did not reach statistical significance.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Numerous investigations have revealed an increased risk of stroke, congestive heart failure, myocardial infarction, and angina in elderly hypertensive individuals 3 – 5 . Furthermore, active treatment has been shown to reduce morbidity in elderly hypertensive subjects 6 …”

mentioning

confidence: 99%

Incidence of Hypertension in an Ambulatory Elderly Population

Davidson

Hale²,

Moore³

et al. 1989

J American Geriatrics Society

Self Cite

View full text Add to dashboard Cite

show abstract

“…Thisisnotauniqueattemptasothermeta-analyses on the same subjectexist,forexample [7][8][9][10][11][12], and re-centlyasimilaranalysisbyBejan-Angoulvat etal. [13].…”

Section: Introductionmentioning

confidence: 99%

Treatment of arterial hypertension in the very elderly: a meta-analysis of clinical trials

Schall

Wehling²

2011

Arzneimittelforschung

View full text Add to dashboard Cite

The benefits of lowering blood pressure are obvious for the population up to the age of 65 years, but whether and, if so, which treatment is beneficial in the very elderly population remains still a matter of debate. We conducted a meta-analysis of randomised controlled clinical trials with duration of at least 12 months and the analysis of cardio- and cerebrovascular endpoints in participants aged 75 years and over. MEDLINE, CENTRAL (Cochrane Central Register of Controlled Trials) and the WHO-ISH Collaboration register were searched until October 20, 2009. Further, references from reviews, trials and previously published meta-analyses were analysed. A total of 10 studies were included providing morbidity and mortality data with a total of 8667 participants in the meta-analysis, with separate analyses for studies on isolated systolic hypertension. There were 148 non-fatal strokes and 287 cardiovascular morbidity and mortality events among treated patients, compared with 176 non-fatal strokes (p = 0.02) and 366 cardiovascular morbidity and mortality events (p = 0.0001) among control patients. Rates of heart failure were significantly reduced (64 vs. 121 events; p = 0.00001), total mortality remained unchanged (odds ratio 0.97). Further, 9 studies with 6933 participants were included in the systematic review of blood pressure reduction trials. The average blood pressure achieved at the end of the studies was 164/83 mmHg in the placebo group and 150/83 mmHg in the treatment group. At the beginning of the study blood pressure was 170.6/ 88.6 mmHg in the placebo group and 175.4/94.6 mmHg in the treatment group. Changes were only significant for systolic blood pressure in the treatment group (p = 0.0008). Treating healthy subjects aged 75 years and older with moderate to severe hypertension reduces non-fatal strokes, cardiovascular morbidity and mortality and the incidence of heart failure but does not change total mortality.

show abstract