Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
N Engl J Med. 2008 May 1;358(18):1887-98. doi: 10.1056/NEJMoa0801369. Epub 2008 Mar 31.

Treatment of hypertension in patients 80 years of age or older.

Collaborators (232)

Bulpitt CJ, Fletcher AE, Beckett NS, Peters R, McCormack T, Potter T, Extremera BG, Sever P, Forette F, Dumitrascu D, Swift C, Tuomilehto J, Coope J, Nachev C, Staessen J, Thijs L, Clarke R, Narkiewicz K, Davidson C, Duggan J, Leonetti G, Gainsborough N, De Vernejoul MC, Wang J, Stoyanovsky V, Tuomilehto J, Clarke R, Waldman A, Walton I, Ritchie C, Fagard R, Evans JG, Williams B, Warne R, Puddey I, Woodward M, Penhall R, Inderjeeth C, Roger S, Scholes R, Johnson C, Celis H, Adriaens G, Onsea W, Cornelli K, Vantroyen D, Cleen P, de Voogt P, Nachev C, Stoyanovsky V, Solakov P, Prokopova R, Mantova E, Smilkova D, Mantov S, Yankulova K, Kermova R, Popov D, Sirakova V, Gergova V, Kamenova D, Grigorov F, Vassileva R, Alahverdian R, Tzekova M, Liu L, Ge H, Wang S, Wang J, Zhang W, Jin S, Ge L, Lu YF, Ma S, Shen L, Guo J, Lv Z, Huang R, Li X, Guo B, Zhang T, Zhang L, Feng J, He Z, Wang J, Deng L, Liu L, Yuan Q, Zhang F, Li H, Wang D, Yang K, Sun M, Liu H, Yan X, Ren F, Tang J, Antikainen R, Strandberg T, Konttila T, Hynninen A, Jääskivi M, Airas J, Jääskeläinen T, Tuomilehto J, Litmanen H, Forette F, Doucet J, Belmin J, Benetos A, Berrut G, Boge T, Bonnefoy M, Carre A, Charasz N, Covillard J, Dantoine T, Escande M, Frances Y, Joire R, Jeandel C, Legrain S, Lion A, Maillet-Vioud M, Escaillas JP, Meaume S, Pfitzenmeyer P, Puisieux F, Quercy E, Rodat O, Soubeyrand J, de Wazieres B, Hindennach H, Lugassy L, Rossi J, Martel M, Paladel JM, Ravier C, Visconti A, Gallet JP, Zygouritsas D, Charles D, Flamand F, Grandmottet G, Grandmottetegermann M, Gevrey C, Mesnier PL, Robert G, Besset-Prat C, Brousse A, Lafont P, Morelli J, Vernede P, Volkmann A, Bodin X, Destrube B, Eoche R, Boye A, Seropian F, Gernigon P, Meker D, Thomere J, Thual Y, Volny F, Grassart E, Herent M, Lejay D, Lopez JP, Mannessier B, Pruvost G, Urbina JC, Duggan J, Anderson C, Lillis S, Gommans J, Grodzicki T, Chodorowski Z, Gaciong Z, Dumitrascu D, Comsa M, Sandru V, Prada G, Dunca-Moisin M, Jianu D, Jinga-Lazar, Enachescu V, Zaharia C, Nikitin Y, Kirichenko A, Olbinskaya L, Olbinskaya L, Martynov A, Zadionchenko V, Moiseev V, Storohzakov G, Nedogoda S, Karpov RS, Barbarash O, Efremushkin G, Kostenko V, Boyarkin M, Churina S, Tyurina T, Ballyuzek M, Ermoshkina L, Timofeev A, Yakusheva S, Shilkina N, Barbarich V, Belhani A, Boughzela E, Soraya S, Youssef-Zouari B, Khalfallah AB, Houman MH, Abida AK, Rajkumar C, Wilkins M, Pandita-Gunawardena ND, Potter J, Ekpo E, Price M, de Kare-Silver N, Starczewski A, Chandran S, Nasar N, Datta-Chaudhuri M, McCormack T, Majmudar N, Gordon A, Brawn L, Solanki T.

Author information

  • 1Care of the Elderly, Division of Medicine, Imperial College London, United Kingdom.

Abstract

BACKGROUND:

Whether the treatment of patients with hypertension who are 80 years of age or older is beneficial is unclear. It has been suggested that antihypertensive therapy may reduce the risk of stroke, despite possibly increasing the risk of death.

METHODS:

We randomly assigned 3845 patients from Europe, China, Australasia, and Tunisia who were 80 years of age or older and had a sustained systolic blood pressure of 160 mm Hg or more to receive either the diuretic indapamide (sustained release, 1.5 mg) or matching placebo. The angiotensin-converting-enzyme inhibitor perindopril (2 or 4 mg), or matching placebo, was added if necessary to achieve the target blood pressure of 150/80 mm Hg. The primary end point was fatal or nonfatal stroke.

RESULTS:

The active-treatment group (1933 patients) and the placebo group (1912 patients) were well matched (mean age, 83.6 years; mean blood pressure while sitting, 173.0/90.8 mm Hg); 11.8% had a history of cardiovascular disease. Median follow-up was 1.8 years. At 2 years, the mean blood pressure while sitting was 15.0/6.1 mm Hg lower in the active-treatment group than in the placebo group. In an intention-to-treat analysis, active treatment was associated with a 30% reduction in the rate of fatal or nonfatal stroke (95% confidence interval [CI], -1 to 51; P=0.06), a 39% reduction in the rate of death from stroke (95% CI, 1 to 62; P=0.05), a 21% reduction in the rate of death from any cause (95% CI, 4 to 35; P=0.02), a 23% reduction in the rate of death from cardiovascular causes (95% CI, -1 to 40; P=0.06), and a 64% reduction in the rate of heart failure (95% CI, 42 to 78; P<0.001). Fewer serious adverse events were reported in the active-treatment group (358, vs. 448 in the placebo group; P=0.001).

CONCLUSIONS:

The results provide evidence that antihypertensive treatment with indapamide (sustained release), with or without perindopril, in persons 80 years of age or older is beneficial. (ClinicalTrials.gov number, NCT00122811 [ClinicalTrials.gov].).

Copyright 2008 Massachusetts Medical Society.

Comment in

PMID:
18378519
[PubMed - indexed for MEDLINE]
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Atypon
    Loading ...
    Write to the Help Desk