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Antihypertensive Agents in Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

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dc.contributor.author Murad, Mohammad Hassan
dc.contributor.author Larrea-Mantilla, Laura
dc.contributor.author Haddad, Abdullah
dc.contributor.author Spencer-Bonilla, Gabriela
dc.contributor.author Serrano, Valentina
dc.contributor.author Rodriguez-Gutierrez, Rene
dc.contributor.author Alvarez-Villalobos, Neri
dc.contributor.author Benkhadra, Khaled
dc.contributor.author Gionfriddo, Michael R.
dc.contributor.author Prokop, Larry J.
dc.contributor.author Brito, Juan P.
dc.contributor.author Ponce, Oscar J.
dc.date.accessioned 2019-07-04T16:59:19Z
dc.date.available 2019-07-04T16:59:19Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6722
dc.description.abstract BACKGROUND: This systematic review summarizes the benefits of treating blood pressure (BP) in individuals 65 years and older. METHODS: We included randomized trials that evaluated BP-lowering medications or BP targets in individuals 65 years and older. Trials were selected and appraised by pairs of independent reviewers. RESULTS: We included 19 trials (42,134 patients). In individuals 65 years or older, antihypertensive therapy was associated with a reduction in all-cause mortality [relative risk: 0.88 (95% CI: 0.81 to 0.94); high certainty evidence; mean follow-up 31 months], cardiovascular mortality, myocardial infarction, heart failure, stroke, and chronic kidney disease. Individuals 75 years or older had a significant reduction in the risk of all-cause and cardiovascular mortality, stroke, and heart failure. Strict systolic BP targets (<120 mm Hg and <130 mm Hg) were associated with a significant reduction in the risk of all-cause and cardiovascular mortality and heart failure, whereas more liberal systolic targets (<150 mm Hg and <160 mm Hg) were associated with lower risk of heart failure and stroke. Older adults with type 2 diabetes mellitus (DM) had lower risk of chronic kidney disease without a significant reduction in other outcomes. However, there was no significant difference in estimates (i.e., interaction) between those with and without DM. CONCLUSIONS: Individuals aged 65 years and older or 75 years and older who receive antihypertensive therapy have statistically significant reduction in the risk of all-cause and cardiovascular mortality, heart failure, and stroke. There was no statistically significant difference in estimates between those with and without DM. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartof urn:issn:1945-7197
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject UNAVAILABLE en_US
dc.title Antihypertensive Agents in Older Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1210/jc.2019-00197
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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