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(Hypertension. 2008;52:608.)
© 2008 American Heart Association, Inc.

Editorial

Recent Clinical Trials

The Good, the Bad, and the Misleading

From the Division of Hypertension, University of Texas Southwestern Medical School, Dallas.

Correspondence to Norman M. Kaplan, Division of Hypertension, University of Texas Southwestern Medical School, 5323 Harry Hines Blvd, Dallas, TX 75390-8586. E-mail norman.kaplan@utsouthwestern.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Results of 3 major clinical trials on the treatment of hypertension have been published recently^1,2 or presented.³ In addition, the validity of data provided in an often-quoted publication of another trial⁴ that had a major impact on nephrological practice⁵ has been seriously questioned.⁶

First, the good trial, Treatment of Hypertension in Patients 80 Years of Age or Older,¹ addressed a major unsettled issue: should antihypertensive drug therapy be given to the very elderly? The need for such a study is obvious, because people >80 years of age are the fastest growing part of our population, and systolic hypertension is almost invariable among them.⁷ The few data available previously on the benefit versus danger of treating them were not encouraging.⁸

Fortunately, Treatment of Hypertension in Patients 80 Years of Age or Older turned out very well, so well that it was stopped prematurely after an average of 1.8 years of treatment because of the strong evidence of benefit with an average blood pressure that was 15/6 mm Hg lower than in the placebo group. Death from cardiovascular disease was reduced by 23%, death from any cause by 21%, stroke by 30%, and heart failure by 64%. As with all trials, some methodologic issues are noted: (1) the subjects were healthier than most people over age 80 years; (2) only one third had isolated systolic hypertension, the usual form of hypertension in the elderly; (3) only half reached the goal of 150/80 mm Hg; and (4) therapy was limited to the diuretic . . . [Full Text of this Article]

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