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Treating Hypertension Only Marginally Reduces Dementia Risk in the Very Elderly
Treating hypertension in the very elderly only marginally reduces their risk for dementia, but it does decrease stroke and total mortality, according to a Lancet Neurology report released online.
HYVET (Hypertension in the Very Elderly Trial) investigators studied some 3300 patients aged 80 or older with systolic pressures between 160 and 200 mm Hg, diastolic pressures below 110, and no evidence of dementia at baseline. The patients were randomized to antihypertensive drug therapy (target, 150/80 mm Hg) or placebo. The study was stopped when the advantage of active treatment with regard to stroke and mortality became apparent.
When analyzed regarding incident dementia, however, there was no difference between the groups. Although when the HYVET results were combined with similar trials, there was a reduction in dementia that just reached statistical significance.
A commentator writes that the results dispel "the commonly held belief among many doctors" that treating hypertension in the very elderly decreases cerebral flow, and thus promotes dementia.
LINK(S):
Lancet Neurology article (Free abstract; full text requires subscription)
Lancet Neurology comment (Subscription required)
Published in Physician's First Watch July 8, 2008
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