Mortality rates and antihypertensive therapy in extreme old age

The impact of hypertension on survival in extremely old age has shown diffe rent features in different studies, with equal or lower mortality rates in hypertensive patients and lower reduction of risk in treated patients. In a population (n = 414) of old community dwellers (mean age 88.4 years) the p revalence of hypertension was 52.2%. Hypertensive patients presented a lowe r mortality rate (14.2 per 100 person-years) as compared to the general pop ulation (15.4) and to non-hypertensives (16.6). Hypertensives were divided into four groups according to treatment. Best survival was shown by patient s under treatment with antihypertensives alone (9.8) or in association with diuretics (9.9), and worst survival by patients under a diuretic-based tre atment (25.1). These data were confirmed by multivariate analysis. The bett er survival of hypertensive very old people could be related to the use of a proper pharmacotherapy. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.