Lowering hypertension benefits elderly greatly

Contrary to the prevailing belief among cardiologists, reducing blood pressure in people over the age of 80 can sharply reduce the number of heart attacks, strokes and deaths, researchers said Monday.

Treatment with one or two inexpensive, well-tolerated drugs produced a 21 per cent drop in overall mortality - such a significant decrease that the study was ended prematurely so all the participants could benefit from the treatment, British researchers said.

The findings were presented at a Chicago meeting of the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions.

Researchers previously had thought, based on small studies, that controlling blood pressure in the elderly might reduce the risk of stroke while increasing the risk of death, requiring them to balance the risks and benefits of therapy.

"Hopefully, we have quashed the idea that this is a balance between risk and benefits - it is all benefits," said epidemiologist Nigel S. Beckett of Imperial College, London, the lead author of the report, which was also published online by the New England Journal of Medicine.

"This was unexpected, it really was," he added.

Dr Marc E. Shelton of Prairie Cardiovascular Consultants in Springfield, Ill., who chaired the meeting and was not involved in the research, added: "This is the first major trial in patients over the age of 80 ... and it gives credence to the fact that you should take [hypertension in this group] seriously."

Although people over 80 account for just 4 per cent of the population now, that fraction is expected to grow to 11 percent to 12 per cent in a couple of decades, Beckett said.

The results "prove that it is not too late to start antihypertensive therapy in older people and expands the upper limit of the age spectrum for which there is evidence from clinical trials of tremendous benefit", Dr John B. Kostis of the University of Medicine and Dentistry of New Jersey wrote in an editorial accompanying the report.