Intensive Hypertension Treatment Better Prevents Strokes

Intensive hypertension treatment may prevent or delay strokes in older adults, according to the results of a recent meta-analysis.

Included were 9 randomized controlled trials published in the MEDLINE or Google Scholar databases until August 31, 2021. A total of 38,779 individuals were included, with a mean age range of 66 to 84 years and study periods that ranged from 2.0 to 5.8 years.

The included trials compared standard hypertension treatment with intensive treatment in adults aged 65 years or older. Standard treatment included untreated, placebo, or less intensive treatment groups. The researchers compared the absolute risk reduction between the control and intervention groups.

The results indicated that intensive hypertensive treatment prevented 1 stroke per 200 persons after 1.7 years. Studies that focused on tighter systolic blood pressure (SBP) control, defined as SBP less than 150 mmHg, resulted in longer time to benefit (TTB).

Further, in older adults with baseline SBP below 150 mmHg, the TTB was significantly longer than 1.7 years. In comparison, the TTB was shorter than 1.7 years in older adults with baseline SBP above 190 mmHg.

 “Given the heterogeneity across studies, the TBB estimates from individual studies may be more relevant for clinical decision-making than our summary estimate,” the researchers noted.

“Since the overwhelming majority of older adults have a life expectancy [greater than] 1.7 years, our results suggest that almost all older adults with hypertension would benefit from treatment,” the authors concluded.

—Leigh Precopio

Reference:

Ho VS, Cenzer IS, Nguyen BT, Lee SJ. Time to benefit for stroke reduction after blood pressure treatment in older adults: a meta-analysis. J Am Geriatr Soc. Published online February 9, 2022. doi: 10.1111/jgs.17684