• V Ruiz-García and R Peiró.
• Unidad de Hospitalización a Domicilio, Hospital La Fe, Conselleria de Sanitat, Valencia. ruiz_vicgar@gva.es
• Aten Primaria. 2000 Nov 15; 26 (8): 533541533-41.

ObjectivesTo describe the benefits of treatment for hypertension in the elderly, the most efficient drugs, those most widely used in clinical practice to reduce morbi-mortality taken from the literature.DesignSystematic review.ParticipantsReview study in Medline and the Cochrane Collaboration database. The antihypertensive pharmacological treatment is described (diuretics high and low dosage, calcium channel blockers, ACE inhibitor, and beta-blockers) administered to elderly people and their outcomes in morbi-mortality.Measurements And Main ResultsReduction in coronary and cerebral morbidity and general, cardiovascular and cerebrovascular mortality.ResultsThere is evidence to suggest that treatment for hypertension is helpful in the elderly, although efficiency is doubtful in patients over 80 years old. For persons aged over 65 general mortality is RR = 0.84 (0.75-0.94) and coronary morbidity RR = 0.80 (0.70-0.92). For persons aged over 80 general mortality is RR = 1 (0.86-1.17) and cardiovascular mortality is RR = 0.94 (0.75-1.18). Not all pharmacological groups produce the same results in mortality and morbidity. Diuretics (low dosage) offer better results than the remaining treatments reducing cardiovascular mortality as well cerebrovascular morbidity.ConclusionsTreatment with drugs in hypertense elderly people is beneficial in terms of mortality and morbidity. Treatment with low dose diuretics, with or without potassium savers, is the elective treatment for hypertension in elderly patients.

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