The treatment of mild hypertension in the elderly, a prospective study using multiple regression analysis

In order to examine the effect of treatment of mild hypertension of the aged, a 4 year prospective trial was performed in 41 placebo and 38 drug-treated patients with an average age of 76.5 years. Patients were matched for blood pressure, sex and age. Patients with cardiovascular complications or blood pressure elevation above 200/110 were categorized as dropouts and totaled 17 cases (41.5%) in the placebo group, and 4 cases (10.5%) in the drug-treated group (p less than 0.01). In diastolic hypertension, dropouts formed 63.6% of the placebo group (mean BP, 170/92), and 9.5% of the drug group (mean BP, 179/94) (p less than 0.001). In systolic hypertension, dropouts were of 15.8% in the placebo group (mean BP, 164/79), and of 11.8% in the drug group (mean BP, 167/79), and no significant difference was observed. In the placebo group, dropouts were significantly higher in patients with pretreatment systolic blood pressure over 170 mmHg or diastolic blood pressure over 90 mmHg. In patients of 75 years of age or more, dropouts were 46.4% in the placebo group, and 13.0% in the drug treated group showing the beneficial effect of drug treatment even in those over the age of 75. However, no beneficial effect was observed over the age of 85. Stepwise multiple regression analysis of total case revealed that the greatest predictor for dropout was the presence of placebo (i.e. no treatment), explaining 12.2% of the variation in future dropout. Similarly, diastolic hypertension explained 7.5%, creatinine 6.7%, and age 4.6% of this variation.(ABSTRACT TRUNCATED AT 250 WORDS)