Lowering BP through medication
Lowering BP through medication decreased risk for CV occasions across nearly all age groups, suggesting age-related BP thresholds must be eliminated from guidelines, researchers pronounced on the European Society of Cardiology Congress. The reductions were regular regardless of baseline systolic BP.
The researchers performed a meta-evaluation of 358,707 members from 51 randomized trials. The median age becomes 69 years, with 12% younger than 55 years (35% women), 35.8% elderly 55 to 64 years (39% women), 35.8% aged 65 to 74 years (42% women), 15.1% elderly 75 to 84 years (52% women) and 1.3% elderly 85 years or older (61% women). “It has been known for quite some time that in older people who have substantially elevated blood pressure, pharmacological blood pressure reduction will prevent cardiovascular events,” Kazem Rahimi, FRCP, DM, MSc, FESC, professor of cardiovascular medicine and population health on the University of Oxford, U.K., stated for the duration of a presentation. “However, randomized proof at the results of treatment in older people when their blood pressure isn't always drastically multiplied has been limited. This has brought about conflicting guiding principle recommendations and variability in care throughout the world.”
The number one final results become fatal or nonfatal stroke, fatal or nonfatal MI, or ischemic heart disease or HF causing death or hospitalization. The effects have been simultaneously published in The Lancet. For every five mm Hg reduction in systolic BP, the hazard for the primary outcome become diminished via way of means of 18% in members more youthful than 55 years (HR = 0.82; 95% CI, 0.76-0.88), 9% in the ones elderly 55 to 64 years (HR = 0.91; 95% CI, 0.88-0.95), 9% in the ones elderly 65 to 74 years (HR = 0.91; 95% CI, 0.88-0.95), 9% in the ones elderly 75 to 84 years (HR = 0.91; 95% CI, 0.87-0.96) and 1% in the ones elderly 85 years or older (HR = 0.99; 95% CI, 0.87-1.12; adjusted P for interaction = .05), according to the researchers. The absolute risk reductions for major CV occasions have been large in older age groups (adjusted P for interaction = .024), according to the researchers.
The RR reduction “had a bit of a diminishing effect in the older groups; however, if one looks at the absolute risk difference, an opposite pattern seems to be evident, where if anything, the absolute risk differences increase at an increasing age, largely reflective of an increase in the risk of major cardiovascular events in the older populations,” Rahimi stated for the duration of the presentation. Rahimi and co-workers discovered the comparable number one final results reduction throughout age for every 3 mm Hg decreasing of diastolic BP.
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