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 .
Antihypertensive therapy in patients above age 60 years (Fourth Interim report of the European Working Party on High Blood pressure in Elderly: EWPHE).
Summary 1 . A total of 450 hypertensive patients above the age of 60 years have entered the double-blind multicentre trial of the European Working Party on High blood pressure in Elderly ( EWPHE ) . After stratification and r and omization half were treated with one capsule daily containing 25 mg of hydrochlorothiazide and 50 mg of triamterene and half were given placebo . In those receiving active treatment , if blood pressure control was not adequate they were given a second capsule and if necessary up to 2 g of methyldopalday . 2 . No significant differences between the groups were present before r and omization . A significant blood pressure difference of 25/10 mmHg was obtained between the groups and maintained during 4 years of follow-up . No major disturbances in serum potassium or serum sodium were noted with the present drug combination . 3 . During the initial phase an increase in serum creatinine and serum uric acid was noted in the actively treated group , which was maintained during the later years . This increase in serum creatinine in the actively treated group was related ( P = 0.003 and r = -0.247 ) to the decrease in sitting systolic blood pressure . Changes in serum uric acid were ( r = 0.3 and P = 0 - 003 ) correlated with the changes in serum creatinine both in the placebo and in the actively treated group , but Correspondence : Professor Dr A. Amery , Hypertension and Cardiovascular Rehabilitation Unit , Academic Hospital , St Raphael , Kapucijnenvoer 35 , B-3000 Leuven , Belgium . independent of the change in creatinine ; the serum uric acid was on average 1 mg higher in the actively treated than in the placebo group . 4 . Fasting blood glucose did not change significantly in the placebo-treated group but in the active treatment group the rise was statistically signficant . 5 . A favourable influence on prognosis by active treatment can be expected on the basis of the blood pressure reduction and in the absence of major electrolytes disturbances . However , the balance between this decreased risk and the increased risk produced by the rise in blood glucose and the other treatment effects remains to be determined . Therefore the trial continues and more patients are being admitted
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 .