Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger people: meta-analysis of randomised trials

被引:546
作者
Turnbull, F. [1 ]
Neal, B. [1 ]
Ninomiya, T. [1 ]
Algerl, C. [1 ]
Arima, H. [1 ]
Barzi, F. [1 ]
Bulpitt, C. [1 ]
Chalmers, J. [1 ]
Fagard, R. [1 ]
Gleason, A. [1 ]
Heritier, S. [1 ]
Li, N. [1 ]
Perkovic, V. [1 ]
Woodward, M. [1 ]
MacMahon, S. [1 ]
机构
[1] Univ Sydney, Blood Pressure Lowering Treatment Trialists Colla, George Inst Int Hlth, Sydney, NSW 2050, Australia
来源
BMJ-BRITISH MEDICAL JOURNAL | 2008年 / 336卷 / 7653期
关键词
D O I
10.1136/bmj.39548.738368.BE
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective To quantify the relative risk reductions achieved with different regimens to lower blood pressure in younger and older adults. Design Meta-analyses and meta-regression analyses used to compare the effects on the primary outcome between two age groups (< 65 v >= 65 years). Evidence for an interaction between age and the effects of treatment sought by fitting age as a continuous variable and estimating overall effects across trials. Main outcome measures Primary outcome: total major cardiovascular events. Results 31 trials, with 190 606 participants, were included. The meta-analyses showed no clear difference between age groups in the effects of lowering blood pressure or any difference between the effects of the drug classes on major cardiovascular events (all P >= 0.24). Neither was there any significant interaction between age and treatment when age was fitted as a continuous variable (all P > 0.09). The meta-regressions also showed no difference in effects between the two age groups for the outcome of major cardiovascular events (< 65 v >= 65; P=0.38). Conclusions Reduction of blood pressure produces benefits in younger (< 65 years) and older (>= 65 years) adults, with no strong evidence that protection against major vascular events afforded by different drug classes varies substantially with age.
引用
收藏
页码:1121 / 1123
页数:23
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