Related Experiment Videos
Prevention of stroke
1Section of Elderly Care, Hammersmith Hospital, London, UK. n.beckett@ic.ac.uk
Insights
Treating hypertension in elderly individuals over 80 or with systolic pressures below 160mmHg is unproven. Evidence supports treating older adults with higher blood pressure to prevent stroke.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Geriatrics
Background:
- Hypertension is a primary modifiable risk factor for stroke.
- Evidence supports treating hypertension in the elderly to prevent stroke.
Purpose of the Study:
- To review the evidence for treating hypertension in elderly individuals.
- To assess the benefits of hypertension treatment for stroke prevention.
Main Methods:
- Review of existing clinical trials and meta-analyses on hypertension treatment in the elderly.
- Analysis of data regarding stroke reduction and secondary prevention.
Main Results:
- Treatment benefits are proven for individuals up to age 80 with systolic pressure >160mmHg or diastolic pressure >90mmHg.
- Diuretics appear more effective than alpha-blockers; calcium-channel blockers may offer stroke reduction benefits, but require further data.
- Benefits for those aged 80+ or with pressures <160mmHg remain unproven.
Conclusions:
- Hypertension management is crucial for stroke prevention in specific elderly populations.
- Further research is needed to clarify optimal treatment strategies and drug classes for all elderly hypertensive patients.
Abstract:
Hypertension is the most important modifiable risk factor for stroke. There is clear and ample evidence of benefit for treating elderly hypertensive subjects up to the age of 80 with systolic pressures of over 160mmHg either alone or in combination with diastolic pressures over 90 mmHg. There is also now evidence of benefit in terms of the secondary prevention of stroke. There is no strong evidence of any clear differences between the different drug classes, apart from alpha-blockers being less effective than diuretics. There is the suggestion from a meta-analysis of comparative trials that calcium-channel blockers may be better in terms of stroke reduction but further data are required and they may have disadvantages when considering the prevention of cardiac events. The benefits of treating individuals with pressures below 160 mmHg systolic or aged 80 or more remain unproven.