Blood Pressure Treatment Cuts Heart Risks in the Elderly

New research finds that treating high blood pressure in patients aged 80 and older can reduce the rate of stroke, heart failure and death from cardiovascular disease.

Many doctors often think that these patients are too old to treat. “We get nihilistic by saying, ‘Someone’s 80 years old, what are going to do at this point?’ The older you are, the less aggressively we treat you,” Dr. Harlan Krumholz, a professor of medicine at Yale University School of Medicine, who was not involved in the study, said, according to the Washington Post.

Dr. Christopher Bulpitt of the Imperial College London and colleagues assigned 3,845 people aged 80 and older to take the diuretic indapamide or dummy pills plus the ACE Inhibitor perindopril as needed to reach a goal of 150/80 from an average starting pressure of 173/91.

Diuretics, one of the most common of the anti-hypertensive drugs, are the most effective for elderly people.

The results of the study, named Hypertension in the Very Elderly Trial, show that, within a year of treatment, there was a 21 percent reduction in mortality, a 39 percent reduction in death from strokes, a 64 percent fall in fatal and non-fatal heart failure, a 34 percent drop in cardiovascular events and a significant reduction in the number of deaths from strokes among those on the treatment.

“Our results clearly show that many patients aged 80 and over could benefit greatly from treatment. Populations are living longer and we have growing numbers of people living well into their 80s and beyond, so this is good news,” Dr. Bulpitt said at a meeting of the American College of Cardiology in Chicago.

There were 170 deaths in the treatment group and 215 deaths among patients who took the placebo, the researchers announced.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles welcomed the findings saying that the new study should encourage doctors to treat elderly patients with high blood pressure more aggressively.

“This study convincingly demonstrates that the benefits of treating high blood pressure in patients aged 80 and above greatly outweighs the risks,” he said.

Professor Graham MacGregor, chairperson of UK charity The Blood Pressure Association said: “These results are great news for older people in the UK. We now need to ensure that, where appropriate, their blood pressure is treated and controlled.”

More than 70 million Americans have high blood pressure and only a third have it well controlled by medicines. Heart experts advise starting on one, usually a “water pill,” and adding others as needed.

The New England Journal of Medicine released the findings of the study Monday.