Glynn RJ, Broch DB, Harris T, Havlik RJ, Chrischilles EA,
Osfeld AM, Taylor JO, Hennekens CH
Use of antihypertensive drugs and trends in blood pressure in
the elderly
Arch Intern Med
(Sep) 155:1855-1860 1995
A number of early studies involving antihypertensive agents in the diuretic
class and, to a lesser extent, in the beta-blocker group, have suggested
benefits
in the elderly patient. This article was an attempt to assess how such
outcomes data have
influenced physician practice, choice of drug, and changes in population
prevalence of various antihypertensive drug classes as a result of this
information. The study patients (n=10,294) were
followed from 1981 at 3 and 6 year intervals. They lived in Conneticut,
Iowa, and
Massachussets, and were all older than 65. Use of all antihypertensives
during the time period in question increased by approximately 15-30%. An
unexplained but interesting finding was that while mean systolic and
diastolic blood pressures and prevalence of systolic hypertension declined
in the New England States they were far less improved in Iowa and, amongst
females, systolic hypertension actually worsened. Despite published data,
there was a decline in the use of thiazides and an increase in ACE inhibitor
and calcium channel blocker use. To no one's surprise, elderly patients
appear to be more agressively treated for hypertension. However, our choice
of therapeutic agents has been driven more by theoretical indications and
convenience/side effect profiles than by long term trials demonstrating true
reductions in morbidity or mortality. Hopefully, with ongoing studies to be
completed in the near future, we can once again claim to be practicing
evidence based medicine.
(Narsipur)
To go back use the BACK button on your browser.
Otherwise click on the desired link to this article below:
H: Diagnosis :
Elderly