A New Mandate for Treating Hypertension in the Elderly

摘要

Introduction: An increasing proportion of the population is reaching the ninth decade of life and beyond. Many of these individuals are active and contributory members of society, but most at this stage of life are hypertensive. Epidemiologic data indicate that for individuals in their 80s, as for younger age groups, increasing levels of systolic blood pressure are associated with increased risks of major cardiovascular events and strokes .Only limited information has been available about whether treating hypertension in older age groups provides the same benefits as demonstrated in large hypertension outcomes studies. The number of patients in their 80s or older in these clinical trials has been insufficient to justify conclusions regarding the value of treating the elderly. Some findings in the Systolic Hypertension in the Elderly Program (SHEP) suggested a reduction in major events in this age group, but patient numbers were inadequate to permit firm conclusions . A meta-analysis based on several hypertension trials indicated that although active treatment decreased stroke incidence in patients in this age group, there appeared to be an offsetting increase in total mortality .