Treating Hypertension in Older Adults in Light of the Recent STEP Trial: Can We Implement the Findings in Geriatric Practice?

AbstractRecently, major trials have explored blood pressure targets that would provide greater benefit and fewer adverse events in older adult population on antihypertensive treatment. The last study was the STEP study conducted in China, which included 8511 older people aged 60 –80 years. When systolic blood pressure below 130 mmHg was targeted in older individuals, there was a 26% risk reduction in cardiovascular outcomes compared with higher (<  150 mmHg) blood pressure values. At this point, it is necessary to evaluate how much the study group represents the older population because this population group is very heterogeneous, and it is not possible to apply a single treatment strategy to all older people. In this context, when we exami ned the baseline characteristics of the study group, we saw that the individuals included in the study consisted mostly of young–older people with less accompanying comorbidities. In addition, vulnerable groups, such as those with dementia and nursing home residents who are susceptible to treatmen t adverse effects, appeared to be excluded from the study. Therefore, this trial is very important as it concludes that the goal of strict blood pressure control is beneficial infit older individuals, but does not guide treatment strategy for other groups. When planning treatments in older adults, it is essential to consider the biological age of individuals and to determine a strategy by evaluating frailty, functionality and cognitive s...
Source: Drugs and Aging - Category: Geriatrics Source Type: research