TABLE 3-2 Impact of Antihypertensive Therapy on Cardiovascular Morbidity and Mortality by Age Group

 

Relative Reductiona (percentage)

Absolute Reductionb (per 1,000 person-years)

Study

< 50 Years

>60 Years

< 50 Years

>60 Years

Veterans Administration Cooperative (morbidity)

55

59

21

100

Hypertension Detection and Follow-up Program (mortality)

6

16

2

25

Australian Trial on Mild Hypertension (cardiovascular trial endpoints)

20

26

5

10

a Relative reduction = the percentage of decline in the event rate in the intervention group compared with the placebo group.

b Absolute reduction = the total number of events prevented in the treatment group versus the comparison group per 1,000 person-years of treatment.

age.7 Yet when these data are analyzed by the absolute number of events prevented per 1,000 person-years of treatment, it is also clear that more total events are prevented in participants over age 60.7 Elderly persons have higher rates of cardiovascular events; if they experience the same percentage of benefit as younger persons from drug treatment for diastolic high blood pressure, then the reduction in total number of events is greater in the older persons. Therefore, the benefit attributable to the treatment of diastolic high blood pressure increases with age and with the severity of the diastolic high blood pressure. The absolute benefit from drug treatment of diastolic high blood pressure in persons over the age of 60 varies from 10 events prevented per 1,000 person-years for individuals with mild diastolic high blood pressure (90 to 104 mmHg) to 100 events per 1,000 person-years for individuals with moderate diastolic high blood pressure (105 to 115 mmHg).

Evidence That Treatment of Isolated Systolic High Blood Pressure Is Beneficial

To date there are no data from randomized controlled trials to demonstrate that treatment of isolated systolic high blood pressure



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement