PLACEBO SUBSTITUTION FOR METHYLDOPA IN GERIATRIC HYPERTENSIVE PATIENTS

The aim of this study was to obtain an objective evaluation of the pos sibly inappropriate anti-hypertensive therapy of elderly patients; thi s was done by means of placebo substitution for methyldopa, one of the drugs taken by all the participating patients. Forty patients were re cruited from a hospital outpatient clinic and randomly allocated to tw o groups. One group remained on treatment which included methyldopa, w hile a matching placebo tablet was substituted in the other group. The study was conducted over a period of 6 months in a single-blind manne r. Methyldopa was reintroduced in the placebo group when one of the ev aluation clauses was recorded. Only 2 patients in the placebo group re quired reintroduction of methyldopa tablets. In the rest of this group there was no significant difference between systolic and diastolic pr essures before and after 6 months of placebo substitution. Withdrawal of unnecessary antihypertensive therapy in the elderly should be consi dered. Patients must be observed carefully and therapy reintroduced wh en blood pressures rise.