Treatment of Hypertension in Patients 80 Years of Age or Older
Identifieur interne : 002A48 ( PascalFrancis/Curation ); précédent : 002A47; suivant : 002A49Treatment of Hypertension in Patients 80 Years of Age or Older
Auteurs : Nigel S. Beckett [Royaume-Uni] ; Ruth Peters [Royaume-Uni] ; Astrid E. Fletcher [Royaume-Uni] ; Jan A. Staessen [Belgique] ; LISHENG LIU [République populaire de Chine] ; Dan Dumitrascu [Roumanie] ; Vassil Stoyanovsky [Bulgarie] ; Riitta L. Antikainen [Royaume-Uni, Finlande] ; Yuri Nikitin [Russie] ; Craig Anderson [Australie] ; Alli Belhani [Tunisie] ; Francoise Forette [France] ; Chakravarthi Rajkumar [Royaume-Uni] ; Lutgarde Thijs [Belgique] ; Winston Banya [Royaume-Uni] ; Christopher J. Bulpitt [Royaume-Uni]Source :
- The New England journal of medicine [ 0028-4793 ] ; 2008.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Personne âgée, Médecine.
English descriptors
Abstract
BACKGROUND Whether the treatment of patients with hypertension who are 80 years of age or older is beneficial is unclear. It has been suggested that antihypertensive therapy may reduce the risk of stroke, despite possibly increasing the risk of death. METHODS We randomly assigned 3845 patients from Europe, China, Australasia, and Tunisia who were 80 years of age or older and had a sustained systolic blood pressure of 160 mm Hg or more to receive either the diuretic indapamide (sustained release, 1.5 mg) or matching placebo. The angiotensin-converting-enzyme inhibitor perindopril (2 or 4 mg), or matching placebo, was added if necessary to achieve the target blood pressure of 150/80 mm Hg. The primary end point was fatal or nonfatal stroke. RESULTS The active-treatment group (1933 patients) and the placebo group (1912 patients) were well matched (mean age, 83.6 years; mean blood pressure while sitting, 173.0/90.8 mm Hg); 11.8% had a history of cardiovascular disease. Median follow-up was 1.8 years. At 2 years, the mean blood pressure while sitting was 15.0/6.1 mm Hg lower in the active-treatment group than in the placebo group. In an intention-to-treat analysis, active treatment was associated with a 30% reduction in the rate of fatal or nonfatal stroke (95% confidence interval [CI], -1 to 51; P=0.06), a 39% reduction in the rate of death from stroke (95% CI, 1 to 62; P=0.05), a 21% reduction in the rate of death from any cause (95% CI, 4 to 35; P=0.02), a 23% reduction in the rate of death from cardiovascular causes (95% CI, -1 to 40; P=0.06), and a 64% reduction in the rate of heart failure (95% CI, 42 to 78; P<0.001). Fewer serious adverse events were reported in the active-treatment group (358, vs. 448 in the placebo group; P= 0.001). CONCLUSIONS The results provide evidence that antihypertensive treatment with indapamide (sustained release), with or without perindopril, in persons 80 years of age or older is beneficial.
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Bulpitt</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Imperial College London</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">08-0239539</idno><date when="2008">2008</date><idno type="stanalyst">PASCAL 08-0239539 INIST</idno><idno type="RBID">Pascal:08-0239539</idno><idno type="wicri:Area/PascalFrancis/Corpus">003599</idno><idno type="wicri:Area/PascalFrancis/Curation">002A48</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Treatment of Hypertension in Patients 80 Years of Age or Older</title><author><name sortKey="Beckett, Nigel S" sort="Beckett, Nigel S" uniqKey="Beckett N" first="Nigel S." last="Beckett">Nigel S. Beckett</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Imperial College London</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Peters, Ruth" sort="Peters, Ruth" uniqKey="Peters R" first="Ruth" last="Peters">Ruth Peters</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Imperial College London</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Fletcher, Astrid E" sort="Fletcher, Astrid E" uniqKey="Fletcher A" first="Astrid E." last="Fletcher">Astrid E. Fletcher</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>London School of Hygiene and Tropical Medicine</s1><s2>London</s2><s3>GBR</s3><sZ>3 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Staessen, Jan A" sort="Staessen, Jan A" uniqKey="Staessen J" first="Jan A." last="Staessen">Jan A. Staessen</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>University of Leuven</s1><s2>Leuven</s2><s3>BEL</s3><sZ>4 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Belgique</country></affiliation></author><author><name sortKey="Lisheng Liu" sort="Lisheng Liu" uniqKey="Lisheng Liu" last="Lisheng Liu">LISHENG LIU</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Beijing Hypertension League Institute</s1><s2>Beijing</s2><s3>CHN</s3><sZ>5 aut.</sZ></inist:fA14><country>République populaire de Chine</country></affiliation></author><author><name sortKey="Dumitrascu, Dan" sort="Dumitrascu, Dan" uniqKey="Dumitrascu D" first="Dan" last="Dumitrascu">Dan Dumitrascu</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Spitaluljudetean Cluj, Clinica Medical 2</s1><s2>Cluj</s2><s3>ROU</s3><sZ>6 aut.</sZ></inist:fA14><country>Roumanie</country></affiliation></author><author><name sortKey="Stoyanovsky, Vassil" sort="Stoyanovsky, Vassil" uniqKey="Stoyanovsky V" first="Vassil" last="Stoyanovsky">Vassil Stoyanovsky</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>National Transport Multi-Profile Hospital</s1><s2>Sofia</s2><s3>BGR</s3><sZ>7 aut.</sZ></inist:fA14><country>Bulgarie</country></affiliation></author><author><name sortKey="Antikainen, Riitta L" sort="Antikainen, Riitta L" uniqKey="Antikainen R" first="Riitta L." last="Antikainen">Riitta L. Antikainen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Imperial College London</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>University of Oulu</s1><s2>Oulu</s2><s3>FIN</s3><sZ>8 aut.</sZ></inist:fA14><country>Finlande</country></affiliation></author><author><name sortKey="Nikitin, Yuri" sort="Nikitin, Yuri" uniqKey="Nikitin Y" first="Yuri" last="Nikitin">Yuri Nikitin</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>State Scientific Research Institute of Internal Medicine</s1><s2>Novosibirsk</s2><s3>RUS</s3><sZ>9 aut.</sZ></inist:fA14><country>Russie</country></affiliation></author><author><name sortKey="Anderson, Craig" sort="Anderson, Craig" uniqKey="Anderson C" first="Craig" last="Anderson">Craig Anderson</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>George Institute for International Health</s1><s2>Sydney</s2><s3>AUS</s3><sZ>10 aut.</sZ></inist:fA14><country>Australie</country></affiliation></author><author><name sortKey="Belhani, Alli" sort="Belhani, Alli" uniqKey="Belhani A" first="Alli" last="Belhani">Alli Belhani</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>L'Etablissement Public de Santé Charles Nicolle, Service de Cardiologie</s1><s2>Tunis</s2><s3>TUN</s3><sZ>11 aut.</sZ></inist:fA14><country>Tunisie</country></affiliation></author><author><name sortKey="Forette, Francoise" sort="Forette, Francoise" uniqKey="Forette F" first="Francoise" last="Forette">Francoise Forette</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Hôpital Broca, University Paris V</s1><s2>Paris</s2><s3>FRA</s3><sZ>12 aut.</sZ></inist:fA14><country>France</country></affiliation></author><author><name sortKey="Rajkumar, Chakravarthi" sort="Rajkumar, Chakravarthi" uniqKey="Rajkumar C" first="Chakravarthi" last="Rajkumar">Chakravarthi Rajkumar</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Brighton and Sussex Medical School</s1><s2>Brighton</s2><s3>GBR</s3><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Thijs, Lutgarde" sort="Thijs, Lutgarde" uniqKey="Thijs L" first="Lutgarde" last="Thijs">Lutgarde Thijs</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>University of Leuven</s1><s2>Leuven</s2><s3>BEL</s3><sZ>4 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Belgique</country></affiliation></author><author><name sortKey="Banya, Winston" sort="Banya, Winston" uniqKey="Banya W" first="Winston" last="Banya">Winston Banya</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Imperial College London</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Bulpitt, Christopher J" sort="Bulpitt, Christopher J" uniqKey="Bulpitt C" first="Christopher J." last="Bulpitt">Christopher J. Bulpitt</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Imperial College London</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author></analytic><series><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age</term><term>Elderly</term><term>Hypertension</term><term>Medicine</term><term>Patient</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Hypertension artérielle</term><term>Traitement</term><term>Malade</term><term>Personne âgée</term><term>Age</term><term>Médecine</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Personne âgée</term><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND Whether the treatment of patients with hypertension who are 80 years of age or older is beneficial is unclear. It has been suggested that antihypertensive therapy may reduce the risk of stroke, despite possibly increasing the risk of death. METHODS We randomly assigned 3845 patients from Europe, China, Australasia, and Tunisia who were 80 years of age or older and had a sustained systolic blood pressure of 160 mm Hg or more to receive either the diuretic indapamide (sustained release, 1.5 mg) or matching placebo. The angiotensin-converting-enzyme inhibitor perindopril (2 or 4 mg), or matching placebo, was added if necessary to achieve the target blood pressure of 150/80 mm Hg. The primary end point was fatal or nonfatal stroke. RESULTS The active-treatment group (1933 patients) and the placebo group (1912 patients) were well matched (mean age, 83.6 years; mean blood pressure while sitting, 173.0/90.8 mm Hg); 11.8% had a history of cardiovascular disease. Median follow-up was 1.8 years. At 2 years, the mean blood pressure while sitting was 15.0/6.1 mm Hg lower in the active-treatment group than in the placebo group. In an intention-to-treat analysis, active treatment was associated with a 30% reduction in the rate of fatal or nonfatal stroke (95% confidence interval [CI], -1 to 51; P=0.06), a 39% reduction in the rate of death from stroke (95% CI, 1 to 62; P=0.05), a 21% reduction in the rate of death from any cause (95% CI, 4 to 35; P=0.02), a 23% reduction in the rate of death from cardiovascular causes (95% CI, -1 to 40; P=0.06), and a 64% reduction in the rate of heart failure (95% CI, 42 to 78; P<0.001). Fewer serious adverse events were reported in the active-treatment group (358, vs. 448 in the placebo group; P= 0.001). CONCLUSIONS The results provide evidence that antihypertensive treatment with indapamide (sustained release), with or without perindopril, in persons 80 years of age or older is beneficial.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0028-4793</s0></fA01><fA02 i1="01"><s0>NEJMAG</s0></fA02><fA03 i2="1"><s0>N. Engl. j. med.</s0></fA03><fA05><s2>358</s2></fA05><fA06><s2>18</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Treatment of Hypertension in Patients 80 Years of Age or Older</s1></fA08><fA11 i1="01" i2="1"><s1>BECKETT (Nigel S.)</s1></fA11><fA11 i1="02" i2="1"><s1>PETERS (Ruth)</s1></fA11><fA11 i1="03" i2="1"><s1>FLETCHER (Astrid E.)</s1></fA11><fA11 i1="04" i2="1"><s1>STAESSEN (Jan A.)</s1></fA11><fA11 i1="05" i2="1"><s1>LISHENG LIU</s1></fA11><fA11 i1="06" i2="1"><s1>DUMITRASCU (Dan)</s1></fA11><fA11 i1="07" i2="1"><s1>STOYANOVSKY (Vassil)</s1></fA11><fA11 i1="08" i2="1"><s1>ANTIKAINEN (Riitta L.)</s1></fA11><fA11 i1="09" i2="1"><s1>NIKITIN (Yuri)</s1></fA11><fA11 i1="10" i2="1"><s1>ANDERSON (Craig)</s1></fA11><fA11 i1="11" i2="1"><s1>BELHANI (Alli)</s1></fA11><fA11 i1="12" i2="1"><s1>FORETTE (Francoise)</s1></fA11><fA11 i1="13" i2="1"><s1>RAJKUMAR (Chakravarthi)</s1></fA11><fA11 i1="14" i2="1"><s1>THIJS (Lutgarde)</s1></fA11><fA11 i1="15" i2="1"><s1>BANYA (Winston)</s1></fA11><fA11 i1="16" i2="1"><s1>BULPITT (Christopher J.)</s1></fA11><fA14 i1="01"><s1>Imperial College London</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>8 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></fA14><fA14 i1="02"><s1>London School of Hygiene and Tropical Medicine</s1><s2>London</s2><s3>GBR</s3><sZ>3 aut.</sZ></fA14><fA14 i1="03"><s1>University of Leuven</s1><s2>Leuven</s2><s3>BEL</s3><sZ>4 aut.</sZ><sZ>14 aut.</sZ></fA14><fA14 i1="04"><s1>Beijing Hypertension League Institute</s1><s2>Beijing</s2><s3>CHN</s3><sZ>5 aut.</sZ></fA14><fA14 i1="05"><s1>Spitaluljudetean Cluj, Clinica Medical 2</s1><s2>Cluj</s2><s3>ROU</s3><sZ>6 aut.</sZ></fA14><fA14 i1="06"><s1>National Transport Multi-Profile Hospital</s1><s2>Sofia</s2><s3>BGR</s3><sZ>7 aut.</sZ></fA14><fA14 i1="07"><s1>University of Oulu</s1><s2>Oulu</s2><s3>FIN</s3><sZ>8 aut.</sZ></fA14><fA14 i1="08"><s1>State Scientific Research Institute of Internal Medicine</s1><s2>Novosibirsk</s2><s3>RUS</s3><sZ>9 aut.</sZ></fA14><fA14 i1="09"><s1>George Institute for International Health</s1><s2>Sydney</s2><s3>AUS</s3><sZ>10 aut.</sZ></fA14><fA14 i1="10"><s1>L'Etablissement Public de Santé Charles Nicolle, Service de Cardiologie</s1><s2>Tunis</s2><s3>TUN</s3><sZ>11 aut.</sZ></fA14><fA14 i1="11"><s1>Hôpital Broca, University Paris V</s1><s2>Paris</s2><s3>FRA</s3><sZ>12 aut.</sZ></fA14><fA14 i1="12"><s1>Brighton and Sussex Medical School</s1><s2>Brighton</s2><s3>GBR</s3><sZ>13 aut.</sZ></fA14><fA17 i1="01" i2="1"><s1>HYVET Study Group</s1><s3>INC</s3></fA17><fA20><s1>1887-1898</s1></fA20><fA21><s1>2008</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>6013</s2><s5>354000183065560030</s5></fA43><fA44><s0>0000</s0><s1>© 2008 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>35 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>08-0239539</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>The New England journal of medicine</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>BACKGROUND Whether the treatment of patients with hypertension who are 80 years of age or older is beneficial is unclear. It has been suggested that antihypertensive therapy may reduce the risk of stroke, despite possibly increasing the risk of death. METHODS We randomly assigned 3845 patients from Europe, China, Australasia, and Tunisia who were 80 years of age or older and had a sustained systolic blood pressure of 160 mm Hg or more to receive either the diuretic indapamide (sustained release, 1.5 mg) or matching placebo. The angiotensin-converting-enzyme inhibitor perindopril (2 or 4 mg), or matching placebo, was added if necessary to achieve the target blood pressure of 150/80 mm Hg. The primary end point was fatal or nonfatal stroke. RESULTS The active-treatment group (1933 patients) and the placebo group (1912 patients) were well matched (mean age, 83.6 years; mean blood pressure while sitting, 173.0/90.8 mm Hg); 11.8% had a history of cardiovascular disease. Median follow-up was 1.8 years. At 2 years, the mean blood pressure while sitting was 15.0/6.1 mm Hg lower in the active-treatment group than in the placebo group. In an intention-to-treat analysis, active treatment was associated with a 30% reduction in the rate of fatal or nonfatal stroke (95% confidence interval [CI], -1 to 51; P=0.06), a 39% reduction in the rate of death from stroke (95% CI, 1 to 62; P=0.05), a 21% reduction in the rate of death from any cause (95% CI, 4 to 35; P=0.02), a 23% reduction in the rate of death from cardiovascular causes (95% CI, -1 to 40; P=0.06), and a 64% reduction in the rate of heart failure (95% CI, 42 to 78; P<0.001). Fewer serious adverse events were reported in the active-treatment group (358, vs. 448 in the placebo group; P= 0.001). CONCLUSIONS The results provide evidence that antihypertensive treatment with indapamide (sustained release), with or without perindopril, in persons 80 years of age or older is beneficial.</s0></fC01><fC02 i1="01" i2="X"><s0>002B01</s0></fC02><fC02 i1="02" i2="X"><s0>002B12B05</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Hypertension artérielle</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Hypertension</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Hipertensión arterial</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Traitement</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Treatment</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Tratamiento</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Malade</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Patient</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Enfermo</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Personne âgée</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Elderly</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Anciano</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Age</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Age</s0><s5>06</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Edad</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Médecine</s0><s5>08</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Medicine</s0><s5>08</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Medicina</s0><s5>08</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Homme</s0></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Human</s0></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Hombre</s0></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>37</s5></fC07><fN21><s1>154</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist></record>Pour manipuler ce document sous Unix (Dilib)
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