Longer, Healthier Lives Offered Senior Citizens
Seeking Treatment for Hypertension
Best approach in patients 80 and up is two drugs
in low doses in an effort to reduce the incidence of stroke
By Joan Vos MacDonald, Contributing Writer Health Behavior News Service
Oct. 20, 2009 – Studies show that older people –
those 60 and older – seeking treatment for hypertension will live
longer, healthier lives. The effects might be more obvious in those who
already have cardiovascular disease, but anti-hypertensive therapy also
benefits other seniors and can help reduce deaths due to stroke as well
as myocardial infarction or sudden cardiac death.
Researchers also urging close monitoring of elderly
with hypertension during weather extremes; second study says thinking
ability varies with blood pressure
The review of 15 studies comprised more than 24,000
participants in which the oldest person was 105 years old and the
average age was 74. Studies took place between 1970 and 2008.
“Before the first definitive clinical-trial
evidence supporting blood–pressure-lowering treatment was produced in
the mid-1980s, systolic hypertension was regarded as a natural feature
of aging and some feared excessive harm from blood-pressure lowering in
this age group,” said lead review author Dr. Vijaya Musini.
Musini is an assistant professor in the department
of anesthesiology, pharmacology and therapeutics at the University of
British Columbia, in Vancouver.
The review appears in the latest issue of The
Cochrane Library, a publication of the Cochrane Collaboration, an
international organization that evaluates medical research. Systematic
reviews draw evidence-based conclusions about medical practice after
considering both the content and quality of existing medical trials on a
topic.
Blood pressure measurements for the study patients
averaged 172/81.
Systolic hypertension — in which the “upper”
blood pressure measurement is 140 or higher — is more likely to occur in
older people and experts now consider it a better predictor of heart
attack and strokes than diastolic blood pressure.
Most of the early studies on hypertension took
place with lower-risk individuals, in their 50’s or younger, which does
not reflect the growing numbers of Americans who are 60 or older or the
increasing numbers of people receiving hypertension diagnoses.
“There are data on people under 60 that treatment
of hypertension is effective and when properly utilized reduces the rate
of stroke, heart attack and death,” said Dr. Scott Wright, a professor
of medicine with the Mayo Clinic. “The majority of cases of hypertension
and especially new cases are probably being diagnosed in those over 60.”
Lifestyle factors associated with aging might play
a part in this group’s increased risk. “Older people also accumulate
higher rates of other risk factors for cardiovascular disease including
obesity, a sedentary life style and diabetes,” Musini said.
The review concluded that treatment for
hypertension reduced the overall number of fatalities whether or not
they were associated with cardiovascular disease. Treating hypertension
can also reduce the risk of stroke and disability, risk factors that are
independent of those for heart disease.
“It is important to update reviews to integrate
new studies that have been published, to review new classes of
medication which might not have been approved or widely utilized 10
years ago, and to remind clinicians of the importance of treating
hypertension,” Wright said.
“Hypertension is easier to treat today than five or
10 years ago because there are better agents, there’s more information
about how to use them and what side effects they might cause.”
The review also found that slightly different
treatment works best for the “oldest old,” people over 80.
“The new conclusions in the updated review are that
most benefit is due to first-line thiazide diuretic therapy for a mean
duration of 4.5 years; that the decrease in all-cause mortality was
limited to persons 60 to 80 years of age; and, that the best approach in
patients 80 years and over is two drugs in low doses in an effort to
reduce the incidence of stroke,” Musini said.
Keep up with the latest news for senior citizens, baby
boomers
Oct. 20, 2009 – Studies show that older people –
those 60 and older – seeking treatment for hypertension will live
longer, healthier lives. The effects might be more obvious in those who
already have cardiovascular disease, but anti-hypertensive therapy also
benefits other seniors and can help reduce deaths due to stroke as well
as myocardial infarction or sudden cardiac death.