The reduction in cardiovascular mortality and morbidity was primarily due to a reduction in cerebrovascular mortality and morbidity .
AUTHORS ' CONCLUSIONS Treating healthy adults 60 years or older with moderate to severe systolic and /or diastolic hypertension with antihypertensive drug therapy reduced all-cause mortality , cardiovascular mortality and morbidity , cerebrovascular mortality and morbidity , and coronary heart disease mortality and morbidity .
Most evidence of benefit pertains to a primary prevention population using a thiazide as first-line treatment
BACKGROUND This is the second substantive up date of this review .
It was originally published in 1998 and was previously up date d in 2009 .
Elevated blood pressure ( known as ' hypertension ' ) increases with age - most rapidly over age 60 .
Systolic hypertension is more strongly associated with cardiovascular disease than is diastolic hypertension , and it occurs more commonly in older people .
It is important to know the benefits and harms of antihypertensive treatment for hypertension in this age group , as well as separately for people 60 to 79 years old and people 80 years or older .
Ambulatory pressure decreases on long‐term placebo treatment in older patients with isolated systolic hypertension
Objective This long-term study investigated the widely accepted hypothesis that ambulatory pressure does not decrease in patients given  placebo . Methods : One hundred and twelve older ( ±60 years ) out patients with isolated systolic hypertension were recruited . Treatment consisted of a placebo during a 3-month baseline period and long-term follow-up . Results : At baseline , on placebo  treatment , clinic systolic/diastolic ( SBP/DBP ) blood pressure ( ±SD ) averaged 176±12/86±7 mmHg and 24-h SBP/DBP 151 ± 15/81 ± 10mmHg . These pressures were unaltered in 51 patients in whom the baseline measurements were repeated after a further month on placebo . After the 112 patients had received placebo for 1 year ( median ) , clinic SBP/DBP fell by 6.6±15.9 ( P < 0.001)/1.4±7.4 (P=0.06)mmHg and 24-h SBP by 2.4±10.7mmHg ( P<0.05 ) , whereas 24-h DBP did not change significantly . The 24-h SBP decreased more with higher baseline level and longer follow-up ( 5–21 months ) . Conclusions : These findings in older patients with isolated systolic hypertension suggest that in long-term studies the ambulatory pressure may slightly but significantly decrease on a placebo . Like those using conventional sphygmomano-metry , long-term studies using non-invasive ambulatory monitoring require a placebo-controlled design
The reduction in cardiovascular mortality and morbidity was primarily due to a reduction in cerebrovascular mortality and morbidity .
AUTHORS ' CONCLUSIONS Treating healthy adults 60 years or older with moderate to severe systolic and /or diastolic hypertension with antihypertensive drug therapy reduced all-cause mortality , cardiovascular mortality and morbidity , cerebrovascular mortality and morbidity , and coronary heart disease mortality and morbidity .
Most evidence of benefit pertains to a primary prevention population using a thiazide as first-line treatment
BACKGROUND This is the second substantive up date of this review .
It was originally published in 1998 and was previously up date d in 2009 .
Elevated blood pressure ( known as ' hypertension ' ) increases with age - most rapidly over age 60 .
Systolic hypertension is more strongly associated with cardiovascular disease than is diastolic hypertension , and it occurs more commonly in older people .
It is important to know the benefits and harms of antihypertensive treatment for hypertension in this age group , as well as separately for people 60 to 79 years old and people 80 years or older .