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.
