Pharmacy World and Science

, Volume 22, Issue 2, pp 31–32 | Cite as

Drug treatment of hypertension in older people: relieving the pressure

  • Marian McDonagh
  • Matthew Bradley
  • Alan Shirley


Hypertension is very common, occurring in over 50% of older people, and is a major risk factor for stroke and ischaemic heart disease. Based on systematic reviews there is evidence to show that drug treatment of hypertension in older people saves lives and prevents unnecessary morbidity. There is also strong evidence to support the use of diuretics as first line agents. Quality of life does not appear to be reduced by antihypertensive drug therapy, although more high quality research is needed. Through the use of drug treatment older people with hypertension can continue to contribute to society and live active lives.

Diuretics Drug therapy Elderly Evidence‐based Hypertension Ischaemic heart disease Quality of life Stroke Systematic review 


  1. 1.
    NHS Centre for Reviews and Dissemination. Drug treatment of essential hypertension in older people. Effectiveness Matters 1999;2.Google Scholar
  2. 2.
    Mulrow C, Lau J, Cornell J and Brand M. Antihypertensive drug therapy in the elderly (Cochrane Review). Update Software 1997.Google Scholar
  3. 3.
    Bulpitt CJ, Fletcher AE, Amery A, Coope J, Evans JG, Lightowlers S, et at. The Hypertension in the Very Elderly Trial (HYVET). Rationale, methodology and comparison with previous trials. Drugs md Aging 1994;3:171-83.Google Scholar
  4. 4.
    Gueyffier F, Bulpitt C, Boissel J, Schron E, Ekbom T, Fagard R, et al. Antihypertensive drugs in very old people: a subgroup meta-analysis of randomised controlled trials. Lancet 1999;793-6.Google Scholar
  5. 5.
    Ramsay L, Williams B, Johnston G, MacGregor G, Poston L, Potter J, et al. Guidelines for management of hypertension: report of the third working party of the British Hypertension Society. Journal of Human Hypertension 1999;569-92.Google Scholar
  6. 6.
    Jackson R. Absolute 5-Year Risk of a Cardiovascular Event (newly diagnosed angina, MI, CHD, death, stroke or TIA). 01/09/99.Google Scholar
  7. 7.
    Havlik RJ and Feinleib M. Epidemiology and genetics of hypertension. Hypertension 1982;5 Pt 2:lii121-7.Google Scholar
  8. 8.
    Messerli FH, Grossman E and Goldbourt U. Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? A systematic review. JAMA 1998;23:1903-7.Google Scholar
  9. 9.
    Beto JA and Bansal VK. Quality of life in treatment of hypertension: a metaanalysis of clinical trials. American Journal of Hypertension 1992:3:195-33.Google Scholar
  10. 10.
    Bennet NE. Hypertension in the elderly [see comments]. Lancet 1994;8920:447-9.Google Scholar
  11. 11.
    Thijs L, Amery A, Antikainen R, Bert P, Birkenhager W, Bulpitt CJ, et al. Antihypertensive therapy in elderly patients with isolated systolic hypertension: third progress report of the Syst-Eur trial. Clinical and Experimental Hypertension 1993; 6:953-66.Google Scholar
  12. 12.
    Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, et al. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) Study Group [see comments]. Lancet 1998;9118:1755-62.Google Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Marian McDonagh
    • 1
  • Matthew Bradley
    • 2
  • Alan Shirley
    • 3
  1. 1.Research Fellow, NHS Centre for Reviews and DisseminationUniversity of YorkYork
  2. 2.Faculty of Pharmacy, Department of Pharmacoepidemiology & PharmacotherapyUtrecht Institute of Pharmaceutical SciencesUtrechtThe Netherlands
  3. 3.Academic Training Fellow, Institute of General Practice and Primary CareUniversity of Sheffield, Northern General HospitalSheffield

Personalised recommendations