Failure of Evidence-based Medicine in the Treatment of Hypertension in Older Patients

摘要

OBJECTIVEThroughout the 1990s, the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure recommended initial antihypertensive therapy with a thiazide diuretic or a β-blocker based on evidence from randomized, controlled trials, unless an indication existed for another drug class. The committee also recommended β-blockers in hypertensive patients with a history of myocardial infarction (MI), and angiotensin-converting enzyme (ACE) inhibitors in patients with congestive heart failure (CHF). Our objective was to determine whether prescribing practices for older hypertensive patients are consistent with evidence-based guidelines.