By Kazuo Ueda, Teruo Omae, Yutaka Hasuo, Masatoshi Fujishima (auth.), Dr. Teruo Omae, Dr. Alberto Zanchetti (eds.)

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Additional info for How Should Elderly Hypertensive Patients Be Treated?: Proceedings of Satellite Symposium to the 12th Scientific Meeting of the International Society of Hypertension, May 1988, Kyoto, Japan

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6. Differences in cerebrovascular mortality (see Fig. 4). From Staessen et al. 043~ , __ _ +20 +40 +60 +80 +100 EWPHE Fig. 7. Differences in coronary mortality (see Fig. From Staessen et al. [3] Coronary Mortality Including Sudden Death Here there is a tendency to decrease in 2 trials and no difference in the other trial (Fig. 7). If one combines the 3 trials, there is a nonsignificant tendency to decrease. Cardiovascular Fatal and Nonfatal Events For every single trial, there was a decrease in cardiovascular events (Fig.

From Staessen et al. ,.. 634 ALL Fig. 10. Differences in fatal and nonfatal coronary events (see Fig. 4). From Staessen et al. [3] 28 A. Amery et al. Why is the Event Rate of Myocardial Infarction Not Reduced by Hypotensive Drug Treatment? Why is there, in these elderly, a c1ear decrease in cerebrovascular events but not a decrease in coronary event rate? This point cannot be discussed in detail, but the possibilities which have been raised are summarized here: 1. In many of these trials, thiazides were the drugs of first choice, which may have affected the results adversely.

If at all possible, drugs requiring once daily administration should be used in order to maximize patient compliance and minimize the risk of confusion caused by complicated drug regimes, particularly since many elderly patients will require specific therapy for more than one condition. In summary, it is sensible practice to institute therapy at the lowest recommended dose and highest dose interval, increasing by sm all increments at infrequent intervals until control of hypertension is achieved.

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