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 .
Clinical trials with ambulatory blood pressure monitoring: fewer patients needed?
We have tested the concept that fewer patients are needed in trials of antihypertensive treatment if blood pressure is measured by ambulatory monitoring rather than by conventional sphygmomanometry .  233 patients ( > or = 60 years old ) with isolated systolic hypertension were r and omly allocated placebo ( n = 119 ) or active treatment ( n = 114 ) . Blood pressure measurements were compared by  Wilcoxon 's test  and blood pressure profiles by ANOVA . With either method of measurement , the same number of patients ( 40 in each treatment group ) was required to show a reduction after 1 year in clinic ( 13/8 mm Hg ) or average blood pressure over 24 h ( 9/5 mm Hg ) . To detect that the decrease in systolic pressure was not steadily maintained through the day , 40 patients in each treatment group were needed for blood pressure profiles made up of 4-hourly or 2-hourly means and 60 for profiles of 1-hourly means . For diastolic pressure , the corresponding numbers were 80 , 100 , and more than the number of available patients , respectively . We conclude that parallel-group trials focusing on the average blood pressure over 24 h , rather than on conventionally measured blood pressure , can not economise on sample size . Moreover , trials study ing the full course of blood pressure throughout the day , require more -- not fewer-- patients than studies of only the conventional or average 24 h blood pressure
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 .