Blood Pressure

Antihypertensive Treatment Lowers All-Cause Mortality in Older Adults

Treatment with antihypertensive medications is associated with a lower risk of all-cause mortality in even the most frail of older adults, with the greatest benefits observed in healthier patients, according to the results of a recent study.1

For their study, the researchers sought to investigate the difference in the effect of antihypertensive treatment in frail and non-frail older adults.

“We knew that high blood pressure medication was protective in general among older people, however, we focused on whether it is also protective in frail patients with many other medical conditions who are usually excluded from randomized trials,” said Giuseppe Mancia, MD, professor emeritus at the University of Milano-Bicocca in Milan, Italy, in an accompanying press release.2

They examined data from 1,283,602 patients aged 65 years and older from a database of residents of the Lombardy Region in Italy. All participants had 3 or more prescriptions of antihypertensive drugs between 2011 and 2012, and were categorized as good, medium, poor, or very poor clinical status using a mortality risk score based on 34 health factors.

Overall, the 7-year death probability ranged from 16% in participants from the good clinical status group to 64% in participants from the very poor clinical status group. Individuals in each clinical status group who had high adherence to antihypertensive treatment had lower all-cause mortality risk than those with very low adherence to treatment (−44%, −43%, −40%, and −33% in the good, medium, poor, and very poor groups, respectively).

“Our findings definitely suggest that even in very frail people, antihypertensive treatment reduces the risk of death; however, the benefits may be smaller in this group,” Mancia said.

—Michael Potts

References:

  1. Rea F, Cantarutti A, Merlino L, et al. Antihypertensive treatment in elderly frail patients: evidence from a large Italian database. Published online June 8, 2020. Hypertension. Doi:10.1161/HYPERTENSIONAHA.120.14683
  2. Blood pressure medications help even the frailest elderly people live longer. News release. Heart.org. June 8, 2020. https://newsroom.heart.org/news/blood-pressure-medications-help-even-the-frailest-elderly-people-live-longer?preview=c609.