Antihypertensive Treatment in the Elderly and Very Elderly: Always “the Lower, the Better?”

Table 1

Efficacy of the antihypertensive treatment in stroke and cardiovascular events in different trials performed in the elderly.

Trial	Mean age at randomization (years)	Subjects enrolled	Mean BP at randomization (mmHg)		Drug treatment	Mean followup (years)	Stroke Reduction (%)	CV events reduction (%)
			SBP	DBP
Coope/Warrender	68	884	196	99	Atenolol; Bendrofluazide	4,04	−30	—
EWPHE	72	840	183	101	HCTZ; Triamterene; Methyldopa	8	NS	− 27
HYVET	84	3845	173	91	Indapamide; Perindopril	2	−30	−34
MRC-HT	70	4396	185	91	Atenolol; HCTZ; Amiloride	5,8	−31	−35
SHEP	72	4716	170	77	Chlorthalidone	4,5	−36	−32
STONE	67	1632	180	90	Nifedipine (Long-acting)	2,5	−57	−60
STOP-HTN	76	1627	195	94	Atenolol; HCTZ; Amiloride; Metoprolol; Pindolol	5	−47	−40
Syst-China	67	3000	171	86	Nitrendipine; Captopril; HCTZ	2	−38	−37
Syst-Eur	70	4695	174	85	Nitrendipine; Enalapril; HCTZ	2	−42	−31

SBP: systolic blood pressure; DBP: diastolic blood pressure; EWPHE: European Working Party on High blood pressure in the Elderly trial; HYVET: hypertension in the very elderly; MCR: Medical Research Council Hypertension Trial; SHEP: systolic hypertension in the elderly; STONE: Shanghai Trial of Hypertension in the Elderly; STOP-HTN: Swedish Trial in Old Patients with Hypertension; Syst-China: systolic hypertension in China; Syst-Eur: Systolic Hypertension in Europe; NS: not significant; HTCZ: hydrochlorothiazide.