Over-80s reap benefits from high BP treatment

American cardiology ConferencE 2008 NICE hypertension guidance, ARBs and glitazone fears.

Treating hypertension in elderly patients can lower mortality rates by up to 20 per cent, a major UK study has shown.

Findings back NICE hypertension guidance to treat high BP in the over-80s with calcium channel blockers or diuretics.

Research presented at the American Cardiology Conference (ACC) in Chicago last week showed that treatment with the diuretic indapamide (1.5g daily) could cut total mortality risk by 21 per cent and stroke risk by 30 per cent.

The randomised controlled study, called HYVET, included 3,845 patients aged an average of 84 years. Patients had a systolic BP of 160-199mmHg and a diastolic BP below 110mmHg.

Patients were followed for an average of 1.8 years. During this time, 48 per cent of those in the treatment arm reached the target BP of 150/80mmHg, compared with 20 per cent given placebo.

Lead researcher Dr Nigel Beckett, from Imperial College London, said: 'HYVET has shown it is never too late to start hypertension treatment.

'We found reductions in the risk of mortality and stroke, which were seen within the first year.'

Dr Terry McCormack, chairman of the Primary Care Cardiovascular Society and a member of the HYVET study steering group, said the findings would give GPs more confidence in treating hypertension in the elderly.

'At the moment, GPs are unsure about treating hypertension in patients over 80,' he said. 'Normally you expect to get an increase in mortality rates because hypertension treatment increases the number of falls in the elderly.

'But this study was surprising as it found that morality rates actually decreased when the patients were treated.'

sanjay.tanday@haymarket.com

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