Hypertension Treatment Beneficial in Very Elderly

Slightly lower dementia risk, but clearly reduces strokes and mortality

TUESDAY, July 8 (HealthDay News) -- Treatment of very elderly patients for high blood pressure may slightly lower the risk of dementia but is clearly beneficial in reducing strokes and mortality, according to research published online July 8 in The Lancet Neurology.

Ruth Peters, Ph.D., from Imperial College London in the United Kingdom, and colleagues randomly assigned 3,336 very elderly hypertensive patients (80 years or older) to 1.5-mg slow-release indapamide (plus the option of an additional 2-4 mg of perindopril), or placebo.

After a mean 2.2 years of follow-up, the researchers found significant decreases in systolic and diastolic blood pressure in the indapamide group. There were 263 cases of dementia, with a lower but statistically insignificant number of cases in the indapamide group (33 versus 38 per 1,000 patient-years, hazard ratio 0.86). However, when these data were pooled with data from other similar placebo-controlled trials of antihypertensive treatment, the risk of dementia was significantly lower after treatment (hazard ratio, 0.87). The trial was stopped early when an interim analysis showed fewer strokes and lower mortality after treatment.

"The…investigators show that short-term antihypertensive treatment is beneficial for stroke and total mortality among the very elderly; therefore, the detection and treatment of hypertension in elderly people, irrespective of whether it prevents dementia, is important because it might prevent cardiovascular disease," Ingmar Skoog, M.D., Ph.D., from Goteborg University in Sweden, writes in an accompanying editorial.

The author of the editorial reports having financial relationships with the pharmaceutical industry.

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