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 .
Long term effects of nisoldipine on the progression of coronary atherosclerosis and the occurrence of clinical events: the NICOLE study
Background : Earlier angiographic studies have suggested that calcium antagonists may prevent the formation of new coronary lesions and the progression of minimal lesions . Conversely , a meta- analysis suggested that these drugs may increase cardiovascular mortality and morbidity in patients with coronary heart disease . Objective : To investigate whether nisoldipine retards the progression of coronary atherosclerosis or reduces the occurrence of clinical events . Design and setting : The NICOLE study ( NIsoldipine  in COronary artery disease in LEuven ) is a single centre , r and omised , double blind , placebo controlled trial with coronary angiography at baseline , six months , and three years of follow up . Patients : 826 patients who had undergone successful coronary angioplasty were r and omised to nisoldipine 40 mg once daily or placebo . The intention to treat and per protocol population consisted of 819 and 578 patients , respectively . Results : In the per protocol population , 625 of the nisoldipine treated and 655 of the placebo treated patients ( NS ) showed angiographic progression in at least one coronary arterial segment , defined as an increase in diameter stenosis of ≥ 13 % . The average minimum luminal diameter of the non-dilated lesions decreased by 0.163 mm and 0.167 mm in the nisoldipine and placebo groups , respectively ( NS ) . The respective numbers of new lesions detected were 7 and 13 ( NS ) . In the intention to treat population , the rates of death , stroke , and acute myocardial infa rct ion were similar in both treatment groups . However , nisoldipine use was associated with fewer revascularisation procedures and thus the percentage of patients with any clinical event was lower ( 44.6 % v 52.6 % , p = 0.02 ) . Conclusions : Nisoldipine has no demonstrable effect on the angiographic progression of coronary atherosclerosis or the risk of major cardiovascular events but its use is associated with fewer revascularisation procedures
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 .