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Contact: ESC Press Office
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European Society of Cardiology
Barcelona, Spain Sunday 31 August 2014: Antihypertensive therapy reduces the risk of cardiovascular (CV) events, strokes and mortality in hypertensive older adults, according to research presented at ESC Congress 2014 today by Dr Maciej Ostrowski from Poland. The findings suggest that antihypertensive drugs should be considered in all patients over 65 years of age with hypertension.
Dr Ostrowski said: “Over the past few decades, a number of randomised trials and meta?analyses have supported the benefits of antihypertensive medication in reducing the incidence of cardiovascular disease (CVD) among hypertensive patients over the age of 65 years. However, these studies were not designed to identify the appropriate target blood pressure (BP) in this population.â€
He added: “There is also still a large debate on the optimal target BP level for older adults with hypertension, especially concerning whether systolic BP reduction below 140 mmHg is beneficial and safe. Experts have emphasised that very limited data exist to make definitive recommendations on how low we should reduce BP in older patients, and that data are lacking on the effects of hypertensive therapy in this group of patients.â€
The aim of the current meta-analysis was to investigate the effect of hypertension therapy on BP, and CV and mortality outcomes in patients over the age of 65 years. The safetyofBP lowering inolder adults was also analysed. The study was performed within theLipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group
The researchers looked at data published during 1966 to 2013 on Scopus, PubMed, Web of Science, and the Cochrane Central Register of randomised controlled trials (RCTs) for appropriate studies. They included 11 RCTs with 40 325 hypertensive older patientsrandomised to receive either antihypertensive drugs or placebo.
They found that BP lowering therapy was associated with a significant reduction in systolic BP (-12.43 mmHg,95% confidence interval
[CI]: -21.07 to -3.79;p=0.005) and diastolic BP (-5.06 mmHg,95%CI: -9.21 to -0.92;p=0.02).
It was also associated with a significant reduction in all-cause mortality rate by 13% (relative risk [RR] 0.87,95%CI: 0.81-0.93;p
There was no significant relation between BP lowering in older adults and the risk ofhospitalisations due to angina pectoris (RR 1.13, 95%CI: 0.9-1.41;p0.05) or heart failure (0.95, 95%CI: 0.76-1.18;p0.05). However an association between BP lowering and the riskof falls was observed (1.21, 95%CI: 1.05-1.44; pDr Ostrowski said: “Antihypertensive therapy in older adults is very effective and should be considered in all patients over 65 years of age with hypertension, as it significantly reduces the risk of CV events, strokes, and mortality. All patients should be made aware of the large benefits of this therapy.â€
He added: “There are still very limited data on possible complications associated with BP lowering in this group of patients, especially the risk of falls whichneeds to be investigated further. Therefore physicians must rememberthat in older patients BP therapy should be individualised, with BP goals adapted to individual tolerability. Within the LBPMC Group we are now conducting a second meta-analysis to answer the question of optimal BP goals in older adults.â€
SUBMITTED TO A SCIENTIFIC JOURNAL: no
SPONSOR: no
REFERS TO SESSION: Dilemmas in the treatment of hypertension http://spo.escardio.org/SessionDetails.aspx?eevtid=69sessId=13930
More information available on ESC Congress 365 after the scientific session: slides and webcast when available (http://congress365.escardio.org/)
Notes to editor
The study will also be presented by Professor Maciej Banach during a rapid fire abstract session on 3 September at 08:30: http://spo.escardio.org/SessionDetails.aspx?eevtid=69sessId=13930†l “.U-iBCvldW2E
Authors: ESC Press Office Tel: +34670 521210 (ESC Spokesperson Coordinator Tanya Kenny)Email: [email protected]
About the European Society of Cardiology
The European Society of Cardiology (ESC) represents more than 80 000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
About ESC Congress 2014
Congress is currently the world’s largest international congress in cardiovascular medicine. ESC Congress 2014 takes place 30 August to 3 September at the Fira Gran Via congress centre in Barcelona, Spain.
This press release accompanies both a presentation and an ESC press conference at the ESC Congress 2014. The press release has been written by the investigator and edited by the ESC and does not necessarily reflect the opinion of the European Society of Cardiology.
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