Pharmacotherapy for Hypertension in Older Adults: A Systematic Review

Leah M. Goeres, Craig D. Williams, Elizabeth Eckstrom, David S H Lee

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

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.

Methods: We searched MEDLINE and ClinicalTrials.gov for studies from 1996 to 2014. Eligible studies included participants aged ≥65 years with hypertension. Eligible studies had clearly defined treatment assignments, blood pressure (BP) targets, and evaluated endpoints of cardiovascular morbidity, mortality, and/or harms of antihypertensive medications. We abstracted study characteristics, cardiovascular benefits, and harms.

Results: Thirty-one articles met the inclusion criteria. Most studies compared different antihypertensive agents and/or placebo groups. These studies consistently demonstrated reduced cardiovascular morbidity and mortality compared with no treatment. Seven studies examined optimal BP targets. Strict control [systolic BP (SBP)

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. There was enormous heterogeneity in these studies, and reporting of harms stratified by age is lacking. The current evidence is insufficient to determine the safest, most beneficial hypertension regimen in older adults.

Original languageEnglish (US)
Pages (from-to)897-910
Number of pages14
JournalDrugs and Aging
Volume31
Issue number12
DOIs
StatePublished - Nov 25 2014

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Hypertension
Drug Therapy
Antihypertensive Agents
Blood Pressure
Morbidity
Mortality
Therapeutics
MEDLINE
Cardiovascular Diseases
Placebos
Guidelines

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

Pharmacotherapy for Hypertension in Older Adults : A Systematic Review. / Goeres, Leah M.; Williams, Craig D.; Eckstrom, Elizabeth; Lee, David S H.

In: Drugs and Aging, Vol. 31, No. 12, 25.11.2014, p. 897-910.

Research output: Contribution to journalArticle

Goeres, Leah M. ; Williams, Craig D. ; Eckstrom, Elizabeth ; Lee, David S H. / Pharmacotherapy for Hypertension in Older Adults : A Systematic Review. In: Drugs and Aging. 2014 ; Vol. 31, No. 12. pp. 897-910.
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