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OBJECTIVE: To quantify the relative risk reductions achieved with different regimens to lower blood pressure in younger and older adults. DESIGN: Meta-analyses and meta-regression analyses used to compare the effects on the primary outcome between two age groups (<65 v > or =65 years). Evidence for an interaction between age and the effects of treatment sought by fitting age as a continuous variable and estimating overall effects across trials. MAIN OUTCOME MEASURES: PRIMARY OUTCOME: total major cardiovascular events. RESULTS: 31 trials, with 190 606 participants, were included. The meta-analyses showed no clear difference between age groups in the effects of lowering blood pressure or any difference between the effects of the drug classes on major cardiovascular events (all P> or =0.24). Neither was there any significant interaction between age and treatment when age was fitted as a continuous variable (all P>0.09). The meta-regressions also showed no difference in effects between the two age groups for the outcome of major cardiovascular events (<65 v > or =65; P=0.38). CONCLUSIONS: Reduction of blood pressure produces benefits in younger (<65 years) and older (> or =65 years) adults, with no strong evidence that protection against major vascular events afforded by different drug classes varies substantially with age.

Original publication

DOI

10.1136/bmj.39548.738368.BE

Type

Journal article

Journal

Bmj

Publication Date

17/05/2008

Volume

336

Pages

1121 - 1123

Keywords

Adult, Age Factors, Aged, Antihypertensive Agents, Cerebrovascular Disorders, Harm Reduction, Heart Diseases, Humans, Hypertension, Middle Aged, Prognosis, Randomized Controlled Trials as Topic, Risk Factors