Blood pressure medications help even the frailest elderly people live
longer

Date:
June 8, 2020
Source:
American Heart Association
Summary:
Taking prescription blood pressure medication helped even the
frailest elderly patients live longer, according to a large study
in Italy. While the improved survival benefit was found in all
older people, the healthier older people survived longer than
those with multiple medical conditions.



FULL STORY ========================================================================== Taking blood pressure medication as prescribed helped even the frailest
elderly people (65 and older) live longer, and the healthiest older
people had the biggest survival boost, according to a large study
in northern Italy published today in Hypertension, an American Heart Association journal.


==========================================================================
"We knew that high blood pressure medication was protective in general
among older people, however, we focused on whether it is also protective
in frail patients with many other medical conditions who are usually
excluded from randomized trials," said Giuseppe Mancia, M.D., lead study
author and professor emeritus at the University of Milano-Bicocca in
Milan, Italy.

Researchers reviewed data on almost 1.3 million people aged 65 and older (average age 76) in the Lombardy region of northern Italy who had 3 or
more high blood pressure medication prescriptions in 2011-2012. Examining
the public health care database, researchers calculated the percentage of
time over the next seven years (or until death) that each person continued
to receive the medications. Because almost all medications are free or
low-cost and dispensed by the public health service, this corresponds
roughly to people's adherence in using the medication in Italy.

To look separately at outcomes among older people with various medical conditions, researchers used a previously developed score that accounts
for 34 different health factors and has a close relationship with
mortality.

Researchers compared roughly 255,000 people who died during the 7-year
follow- up with age-, gender-, and health-status-matched controls who
survived and divided them into four groups of health status: good,
medium, poor or very poor.

The probability of death over 7-years was 16% for people rated in good
health at the beginning of the study. Mortality probability increased progressively to 64% for those rated in very poor health.



========================================================================== Compared with people with very low adherence to blood pressure medications (dispensed pills covered less than 25% of the time period), people with
high adherence to blood pressure medications (more than 75% of the time
period covered) were:
* 44% less likely to die if they started in good health; and
33% less likely to die if they started in very poor health.

A similar pattern was seen with cardiovascular deaths. The greatest
survival benefit was among the people who started in good health, and the
most modest survival benefit was in those who started in very poor health.

"Our findings definitely suggest that even in very frail people, antihypertensive treatment reduces the risk of death; however, the
benefits may be smaller in this group," Mancia said.

No matter what a person's initial health status, survival benefits were greatest in those who received blood pressure medication to cover more
than 75% of the follow-up period, compared with those with intermediate (25-75%) or low levels (less than 25%) of coverage, highlighting the
importance of consistent use of blood pressure medications.

"Do your best to encourage and support patients to take their medications, because adherence is crucial to getting the benefits. Medications do
nothing if people don't take them," Mancia said.

Prescription medications given to elderly people living in nursing
homes or assisted-living homes in Italy are not included in the national database, so the study's results may only apply to elderly people living
in the community.

In addition, all data for this analysis are from Italy, where
hospitalizations and blood pressure medications are available for free
or at low cost, thus, the study's findings may not be generalizable to countries with a different health care system.


========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Federico Rea, Anna Cantarutti, Luca Merlino, Andrea Ungar, Giovanni
Corrao, Giuseppe Mancia. Antihypertensive Treatment in Elderly Frail
Patients. Hypertension, 2020; DOI: 10.1161/HYPERTENSIONAHA.120.14683 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200608092947.htm

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