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A placebo-controlled crossover study of ketanserin in elderly hypertensive patients
S T McCarthy1, G L McCarthy, S M John
1Department of Geriatric Medicine, Radcliffe Infirmary, Oxford, UK.
Insights
Ketanserin effectively lowers blood pressure and heart rate in elderly patients with hypertension. This treatment also significantly improved the quality of life for participants in the study.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Clinical Pharmacology
Background:
- Elderly patients represent the largest group of hypertensive individuals.
- Hypertension treatment in the elderly is crucial for reducing cardiovascular morbidity and mortality.
- Previous studies indicate significant benefits of treating hypertension in older adults.
Purpose of the Study:
- To evaluate the efficacy and tolerability of ketanserin in elderly hypertensive patients.
- To assess the impact of ketanserin on blood pressure, heart rate, and quality of life.
- To investigate the safety profile of ketanserin in this demographic.
Main Methods:
- A study involving seventeen elderly patients (over 70 years) with hypertension (systolic BP ≥ 160 mmHg and/or diastolic BP ≥ 90 mmHg).
- A 12-week placebo-controlled trial comparing ketanserin treatment with placebo.
- Measurements included supine and erect blood pressure, heart rate, 24-hour ambulatory ECG, and routine laboratory tests.
Main Results:
- Ketanserin significantly reduced both systolic and diastolic blood pressure in supine and erect positions (p < 0.001).
- A significant reduction in heart rate was observed (p < 0.001).
- No significant adverse effects on heart rhythm, hematology, electrolytes, biochemistry, or urinalysis were noted. Quality of life scores significantly improved (p = 0.002).
Conclusions:
- Ketanserin is an effective antihypertensive agent in elderly patients.
- The drug demonstrates a favorable safety profile with no significant impact on cardiac rhythm or laboratory parameters.
- Ketanserin treatment leads to a significant improvement in the quality of life for elderly individuals with hypertension.
Abstract:
The results of the European Working Party for Hypertension in the Elderly Study showed that treatment of high blood pressure reduced the morbidity and mortality from strokes and myocardial infarction and reduced the incidence of heart failure in elderly patients. The largest number of hypertensive patients are elderly, and it is in this group of patients that the maximum benefit of treatment might be expected. The present study was designed to study in detail the efficacy and tolerability of ketanserin in an elderly population. Seventeen elderly (greater than 70 years) patients with a lying systolic blood pressure of 160 mmHg and/or a diastolic blood pressure of greater than or equal to 90 mmHg were included in the study. For the 12 patients who completed the study, the mean blood pressure was significantly reduced on ketanserin compared with placebo (p less than 0.001) in the supine and erect positions. The mean net changes in blood pressure after 8 weeks were 21/17 mmHg and 23/16 mmHg erect. Heart rate was also significantly reduced (p less than 0.001) by a mean of 8 beats/min lying and 9 beats/min erect. Analysis of ambulatory 24-hour ECG tapes showed no significant effect of ketanserin on heart rhythms. Ketanserin therapy had no significant effect on routine hematology, plasma electrolytes, biochemistry, or urinalysis. Total exchangeable sodium and potassium and body weight were also unchanged. On ketanserin treatment, the overall quality of life score was significantly improved (p = 0.002; analysis of variance on log transformed data) compared with the placebo phase.