Treatment of elevated blood pressure in the very elderly: less is better

Abstract

Risk of serious adverse cardiovascular events increases with advancing age and with higher blood pressure. Falls and other serious adverse events associated with postural hypotension also increase with age and with antihypertensive drug therapy. It is therefore important to know whether drug treatment improves not only cardiovascular outcomes, but also measures of net health which combine benefit and harm: total mortality and all patients with any serious adverse event (see Therapeutics Letter 42 at www.ti.ubc.ca). This Letter focuses on the best available evidence about drug treatment of elevated blood pressure in individuals over 79 years of age.