Strict control [ systolic BP ( SBP ) < 140 mmHg ] was not consistently better than mild control ( SBP < 150 mmHg ) for adults aged ≥65 years .
Mild SBP control benefitted subjects in all age ranges over 65 years .
Conclusions In this review , older adults with hypertension had decreased cardiovascular morbidity and mortality  with antihypertensives compared with no treatment .
Strict control was not consistently better than mild control in older adults .
The current evidence is insufficient to determine the safest , most beneficial hypertension regimen in older adults
Background Hypertension increases with increasing age .
Optimal treatment of hypertension is important to reduce cardiovascular disease .
Recent guidelines for hypertension have made recommendations for older adults but are supported by evidence that includes younger individuals .
This systematic review evaluates the benefits and harms of antihypertensive agents in adults aged ≥65 years .
Artist® Tablets (Carvedilol) for Hypertensive Patients in Japan
Abstract Background : In Japan , when pharmaceutical companies launch a new drug , they are obligated to conduct a post-marketing survey to evaluate the safety and efficacy of the drug in accordance with Good Post-Marketing Surveillance Practice under Article 14 - 4 ( re-examination ) of the Pharmaceutical Affairs Law at contracted medical institutions . We report the results of a long-term special survey that we conducted as a post-marketing survey . Objective : The results of a prospect i ve post-marketing survey that was conducted to assess the safety and efficacy of the b-adrenergic receptor antagonist ( β-blocker ) Artist ® tablets 10 mg , 20 mg ( carvedilol ) in patients with hypertension in Japan , were investigated in order to examine the safety and efficacy of the drug during long-term treatment ( 18 months ) . Patients : Patients were carvedilol-naive and had essential hypertension or renal parenchymal hypertension . Methods : We performed this survey as a prospect i ve cohort study ( special survey ) utilizing a central ized registration method over 3 years ( starting from April 1994 ) , for an observation period of 18 months of carvedilol treatment . Results : Sixty-one medical institutions across Japan collected 380 case report forms of patients who received long-term administration of carvedilol , with 363 and 341 cases evaluated for safety and efficacy , respectively . The discontinuation rate was 7.2 % and the incidence of adverse drug reactions was 5.23 % ( 19 of 363 ) in the safety population . There was no significant change in fasting plasma glucose levels from baseline ( 118.1 ± 46.5mg/dL ) to after carvedilol treatment ( 114.6 ± 43.3 mg/dL ) [ n = 141 ; p = 0.310].In 341 evaluable patients in the efficacy population , decreases in both blood pressure and pulse rate were statistically significant at all assessment points in comparison with baseline data ( p < 0.001 ) . Similarly , in hypertensive patients with diabetes  mellitus , decreases in blood pressure were statistically significant at all assessment points in comparison with baseline data ( p < 0.001 ) . Conclusions : The results of this study show that carvedilol exerted stable antihypertensive effects leading to favorable blood pressure control throughout long-term treatment , without showing any safety concerns . It was concluded that there were no clinical ly significant issues in terms of safety or efficacy with the long-term treatment of carvedilol in patients with hypertension
Strict control [ systolic BP ( SBP ) < 140 mmHg ] was not consistently better than mild control ( SBP < 150 mmHg ) for adults aged ≥65 years .
Mild SBP control benefitted subjects in all age ranges over 65 years .
Conclusions In this review , older adults with hypertension had decreased cardiovascular morbidity and mortality  with antihypertensives compared with no treatment .
Strict control was not consistently better than mild control in older adults .
The current evidence is insufficient to determine the safest , most beneficial hypertension regimen in older adults
Background Hypertension increases with increasing age .
Optimal treatment of hypertension is important to reduce cardiovascular disease .
Recent guidelines for hypertension have made recommendations for older adults but are supported by evidence that includes younger individuals .
This systematic review evaluates the benefits and harms of antihypertensive agents in adults aged ≥65 years .