Whether the treatment of patients with hypertension who are 80 years of age or older is beneficial is unclear. It has been suggested that antihypertensive therapy may reduce the risk of stroke, despite possibly increasing the risk of death. METHODS: We randomly assigned 3845 patients from Europe, China, Australasia, and Tunisia who were 80 years of age or older and had a sustained systolic blood pressure of 160 mm Hg or more to receive either the diuretic indapamide (sustained release, 1.5 mg) or matching placebo. The angiotensin-converting-enzyme inhibitor perindopril (2 or 4 mg), or matching placebo, was added if necessary to achieve the target blood pressure of 150/80 mm Hg. The primary end point was fatal or nonfatal stroke. RESULTS: The active-treatment group (1933 patients) and the placebo group (1912 patients) were well matched (mean age, 83.6 years; mean blood pressure while sitting, 173.0/90.8 mm Hg); 11.8% had a history of cardiovascular disease. Median follow-up was 1.8 years. At 2 years, the mean blood pressure while sitting was 15.0/6.1 mm Hg lower in the active-treatment group than in the placebo group. In an intention-to-treat analysis, active treatment was associated with a 30% reduction in the rate of fatal or nonfatal stroke (95% confidence interval [CI], -1 to 51; P=0.06), a 39% reduction in the rate of death from stroke (95% CI, 1 to 62; P=0.05), a 21% reduction in the rate of death from any cause (95% CI, 4 to 35; P=0.02), a 23% reduction in the rate of death from cardiovascular causes (95% CI, -1 to 40; P=0.06), and a 64% reduction in the rate of heart failure (95% CI, 42 to 78; P<0.001). Fewer serious adverse events were reported in the active-treatment group (358, vs. 448 in the placebo group; P=0.001). CONCLUSIONS: The results provide evidence that antihypertensive treatment with indapamide (sustained release), with or without perindopril, in persons 80 years of age or older is beneficial. (ClinicalTrials.gov number, NCT00122811 [ClinicalTrials.gov].). Copyright 2008 Massachusetts Medical Society.

• MeSH
• antihypertenziva škodlivé účinky   terapeutické užití   MeSH
• cévní mozková příhoda mortalita   prevence a kontrola   MeSH
• diuretika škodlivé účinky   terapeutické užití   MeSH
• dvojitá slepá metoda MeSH
• hypertenze farmakoterapie   mortalita   MeSH
• indapamid škodlivé účinky   terapeutické užití   MeSH
• inhibitory ACE škodlivé účinky   terapeutické užití   MeSH
• Kaplanův-Meierův odhad MeSH
• kardiovaskulární nemoci epidemiologie   prevence a kontrola   MeSH
• kombinovaná farmakoterapie MeSH
• krevní tlak účinky záření   MeSH
• lidé MeSH
• následné studie MeSH
• perindopril škodlivé účinky   terapeutické užití   MeSH
• senioři nad 80 let MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• ženské pohlaví MeSH

• MeSH
• kouření škodlivé účinky   MeSH
• lidé MeSH
• makulární degenerace MeSH
• obezita MeSH
• patologická angiogeneze MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• recenze MeSH