Antihypertensive Agents in Older Adults

A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Mohammad H Murad, Laura Larrea-Mantilla, Abdullah Haddad, Gabriela Spencer-Bonilla, Valentina Serrano, Rene Rodriguez-Gutierrez, Neri Alvarez-Villalobos, Khaled Benkhadra, Michael R. Gionfriddo, Larry J. Prokop, Juan Brito Campana, Oscar J. Ponce

Research output: Contribution to journalArticle

Abstract

BACKGROUND: This systematic review summarizes the benefits of treating blood pressure (BP) in individuals 65 years and older. METHODS: We included randomized trials that evaluated BP-lowering medications or BP targets in individuals 65 years and older. Trials were selected and appraised by pairs of independent reviewers. RESULTS: We included 19 trials (42,134 patients). In individuals 65 years or older, antihypertensive therapy was associated with a reduction in all-cause mortality [relative risk: 0.88 (95% CI: 0.81 to 0.94); high certainty evidence; mean follow-up 31 months], cardiovascular mortality, myocardial infarction, heart failure, stroke, and chronic kidney disease. Individuals 75 years or older had a significant reduction in the risk of all-cause and cardiovascular mortality, stroke, and heart failure. Strict systolic BP targets (<120 mm Hg and <130 mm Hg) were associated with a significant reduction in the risk of all-cause and cardiovascular mortality and heart failure, whereas more liberal systolic targets (<150 mm Hg and <160 mm Hg) were associated with lower risk of heart failure and stroke. Older adults with type 2 diabetes mellitus (DM) had lower risk of chronic kidney disease without a significant reduction in other outcomes. However, there was no significant difference in estimates (i.e., interaction) between those with and without DM. CONCLUSIONS: Individuals aged 65 years and older or 75 years and older who receive antihypertensive therapy have statistically significant reduction in the risk of all-cause and cardiovascular mortality, heart failure, and stroke. There was no statistically significant difference in estimates between those with and without DM.

Original languageEnglish (US)
Pages (from-to)1575-1584
Number of pages10
JournalThe Journal of clinical endocrinology and metabolism
Volume104
Issue number5
DOIs
StatePublished - May 1 2019

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Antihypertensive Agents
Meta-Analysis
Randomized Controlled Trials
Heart Failure
Blood pressure
Blood Pressure
Risk Reduction Behavior
Mortality
Medical problems
Stroke
Chronic Renal Insufficiency
Diabetes Mellitus
Myocardial Infarction
Type 2 Diabetes Mellitus
Therapeutics

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Murad, M. H., Larrea-Mantilla, L., Haddad, A., Spencer-Bonilla, G., Serrano, V., Rodriguez-Gutierrez, R., ... Ponce, O. J. (2019). Antihypertensive Agents in Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. The Journal of clinical endocrinology and metabolism, 104(5), 1575-1584. https://doi.org/10.1210/jc.2019-00197

Antihypertensive Agents in Older Adults : A Systematic Review and Meta-Analysis of Randomized Clinical Trials. / Murad, Mohammad H; Larrea-Mantilla, Laura; Haddad, Abdullah; Spencer-Bonilla, Gabriela; Serrano, Valentina; Rodriguez-Gutierrez, Rene; Alvarez-Villalobos, Neri; Benkhadra, Khaled; Gionfriddo, Michael R.; Prokop, Larry J.; Brito Campana, Juan; Ponce, Oscar J.

In: The Journal of clinical endocrinology and metabolism, Vol. 104, No. 5, 01.05.2019, p. 1575-1584.

Research output: Contribution to journalArticle

Murad, MH, Larrea-Mantilla, L, Haddad, A, Spencer-Bonilla, G, Serrano, V, Rodriguez-Gutierrez, R, Alvarez-Villalobos, N, Benkhadra, K, Gionfriddo, MR, Prokop, LJ, Brito Campana, J & Ponce, OJ 2019, 'Antihypertensive Agents in Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials', The Journal of clinical endocrinology and metabolism, vol. 104, no. 5, pp. 1575-1584. https://doi.org/10.1210/jc.2019-00197
Murad, Mohammad H ; Larrea-Mantilla, Laura ; Haddad, Abdullah ; Spencer-Bonilla, Gabriela ; Serrano, Valentina ; Rodriguez-Gutierrez, Rene ; Alvarez-Villalobos, Neri ; Benkhadra, Khaled ; Gionfriddo, Michael R. ; Prokop, Larry J. ; Brito Campana, Juan ; Ponce, Oscar J. / Antihypertensive Agents in Older Adults : A Systematic Review and Meta-Analysis of Randomized Clinical Trials. In: The Journal of clinical endocrinology and metabolism. 2019 ; Vol. 104, No. 5. pp. 1575-1584.
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AU - Serrano, Valentina

AU - Rodriguez-Gutierrez, Rene

AU - Alvarez-Villalobos, Neri

AU - Benkhadra, Khaled

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