Document Detail

Should we prefer different drugs to treat hypertension in older and younger adults? Practical implications of clinical trials: European perspective.
MedLine Citation:
PMID:  18846987     Owner:  NLM     Status:  MEDLINE    
Guidelines for the management of hypertension almost invariably include sections where the evidence for or against treatment or for certain types of treatment in certain types of patients is inconclusive. This is especially the case of older patients with hypertension. As a consequence, although a large number of randomized trials including hypertensive patients aged > or = 60 years showed that antihypertensive drugs reduce cardiovascular morbidity and mortality, health care professionals who take care of older adults have been often reluctant to provide adequate antihypertensive therapy. In a recent meta-analysis, the Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC) compared the effects of different drugs for reducing blood pressure (BP) in older and younger adults; the reduction in BP levels and the relative risk reduction of a cardiovascular event with various antihypertensive drugs occurred independently of the patients' ages, and the benefits of antihypertensive regimens based on different drug classes were widely comparable across age groups. The BPLTTC analysis strongly suggests an early and aggressive management of hypertension irrespectively of age; more myocardial infarctions, strokes, heart failures and deaths will be prevented by treating hypertensive patients aged > or = 65 years than by treating patients < or = 50 years with the same BP levels. Antihypertensive treatment should be embedded within the management of global cardiovascular risk, with the use of charts for stratifying risk based on additional risk factors, target organ damage or additional clinical conditions.
Paolo Verdecchia; Giorgio Gentile; Fabio Angeli; Gianpaolo Reboldi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Polskie Archiwum Medycyny Wewn?trznej     Volume:  118     ISSN:  0032-3772     ISO Abbreviation:  Pol. Arch. Med. Wewn.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-13     Completed Date:  2009-01-14     Revised Date:  2010-04-01    
Medline Journal Info:
Nlm Unique ID:  0401225     Medline TA:  Pol Arch Med Wewn     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  513-6     Citation Subset:  IM    
Department of Cardiology, Clinical Research Unit "Preventive Cardiology" Hospital "Santa Maria della Misericordia", Perugia, Italy.
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MeSH Terms
Age Factors
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers / pharmacology,  therapeutic use*
Angiotensin-Converting Enzyme Inhibitors / pharmacology,  therapeutic use*
Antihypertensive Agents / pharmacology,  therapeutic use*
Blood Pressure / drug effects
Calcium Channel Blockers / pharmacology,  therapeutic use*
Heart Failure / prevention & control
Hypertension / drug therapy*
Meta-Analysis as Topic
Risk Assessment
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers

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