Renal function in the elderly: results from the European Working Party on High Blood Pressure in the Elderly trial

Area of Science:

• Nephrology
• Cardiology
• Pharmacology

Background:

• Hypertension is a significant risk factor for cardiovascular and renal complications.
• The potential benefits of antihypertensive treatment on renal function in elderly patients remain a subject of investigation.

Purpose of the Study:

• To analyze the effects of antihypertensive treatment on renal function in a cohort of hypertensive patients.
• To evaluate whether combination therapy with triamterene and hydrochlorothiazide can prevent renal deterioration.

Main Methods:

• Prospective, double-blind study involving 840 patients.
• Random assignment to either placebo or active treatment (triamterene and hydrochlorothiazide).
• Five-year follow-up period with monitoring of serum creatinine levels.

Main Results:

• Serum creatinine levels increased significantly in the actively treated group but not in the placebo group.
• Four treated patients and one placebo patient died of renal causes.
• Four treated patients discontinued the study due to a >100% increase in serum creatinine.

Conclusions:

• The combination of triamterene and hydrochlorothiazide did not prevent renal deterioration over five years.
• The incidence of renal complications in elderly hypertensive patients appears to be low.
• Current data do not support the hypothesis that this antihypertensive treatment prevents renal deterioration.