[Arterial hypertension in persons older than 80 years: the problem can be successfully solved]

It has been noted in recommendations of the European Society of Hypertension (ESH) and of the European Society of Cardiology (2007) that there are no data on effects of antihypertensive therapy on risk of development of cardiovascular complications in patients older than 80 years. In the recently completed study HYVET on 3845 patients aged>80 years (mean age 83 years) with arterial pressure (AP)>160 mm Hg as criterion of inclusion, and target AP below 150/80 mm Hg at the background of 1.5 mg of indapamide retard with or without addition of 2-4 mg of perindopril, 30% lowering of risk of development of fatal and nonfatal stroke (95% confidence interval [CI] -1 to 51, p=0.06), 21% lowering of risk of all-cause death (95%CI 4 to 35, p=0.02), 23% lowering o f risk of cardiovascular death (95%CI -1 to 40, p=0.06), and 64% lowering of risk of development of heart failure (95%CI 42 to 78, p<0.001) were observed. Thus lowering of elevated AP in persons older than 80 years leads to substantial decrease of total mortality, rate of development of fatal stroke and heart failure, improvement of prognosis of life.