Christine Parsons1, Mohammad Hassan Murad2, Stuart Andersen1, Farouk Mookadam3, Helene Labonte1. 1. Deptartment of Internal Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA. 2. Division of Preventive Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA. 3. Division of Cardiovascular Diseases, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA.
Abstract
AIM: To evaluate the effectiveness of antihypertensives in reducing neurocognitive outcomes in elderly patients. PATIENTS & METHODS: We conducted a systematic literature search of randomized trials in which hypertensive patients with a mean age ≥65 years received antihypertensive or control treatment. Outcomes were stroke, transient ischemic attack, cognitive decline and dementia. We included 14 trials for meta-analysis. RESULTS: Compared to placebo, antihypertensive treatment reduced the risk of stroke (RR: 0.67 [95% CI: 0.57-0.79]). Reduced risk was significant for transient ischemic attack, fatal stroke, nonfatal stroke and total stroke. There were insufficient data to compare individual agents. CONCLUSION: Antihypertensive treatment is associated with a significant reduction in stroke in elderly individuals. Reductions in dementia and cognitive decline were not significant; however, there was short follow-up. Comparative effectiveness evidence is limited.
AIM: To evaluate the effectiveness of antihypertensives in reducing neurocognitive outcomes in elderly patients. PATIENTS & METHODS: We conducted a systematic literature search of randomized trials in which hypertensivepatients with a mean age ≥65 years received antihypertensive or control treatment. Outcomes were stroke, transient ischemic attack, cognitive decline and dementia. We included 14 trials for meta-analysis. RESULTS: Compared to placebo, antihypertensive treatment reduced the risk of stroke (RR: 0.67 [95% CI: 0.57-0.79]). Reduced risk was significant for transient ischemic attack, fatal stroke, nonfatal stroke and total stroke. There were insufficient data to compare individual agents. CONCLUSION: Antihypertensive treatment is associated with a significant reduction in stroke in elderly individuals. Reductions in dementia and cognitive decline were not significant; however, there was short follow-up. Comparative effectiveness evidence is limited.
Authors: Ingrid Ekström; Maria Larsson; Debora Rizzuto; Johan Fastbom; Lars Bäckman; Erika J Laukka Journal: J Gerontol A Biol Sci Med Sci Date: 2020-11-13 Impact factor: 6.053