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The effect of antihypertensive treatment on the incidence of stroke and cognitive decline in the elderly: a meta-analysis

    Christine Parsons

    Deptartment of Internal Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA

    ,
    Mohammad Hassan Murad

    Division of Preventive Medicine, Mayo Clinic, 200 1 St SW, Rochester, MN 55905, USA

    ,
    Stuart Andersen

    Deptartment of Internal Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA

    ,
    Farouk Mookadam

    *Author for correspondence:

    E-mail Address: mookadam.farouk@mayo.edu

    Division of Cardiovascular Diseases, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259, USA

    &
    Helene Labonte

    Deptartment of Internal Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA

    Published Online:https://doi.org/10.2217/fca.15.90

    Aim: To evaluate the effectiveness of antihypertensives in reducing neurocognitive outcomes in elderly patients. Patients & methods: We conducted a systematic literature search of randomized trials in which hypertensive patients with a mean age ≥65 years received antihypertensive or control treatment. Outcomes were stroke, transient ischemic attack, cognitive decline and dementia. We included 14 trials for meta-analysis. Results: Compared to placebo, antihypertensive treatment reduced the risk of stroke (RR: 0.67 [95% CI: 0.57–0.79]). Reduced risk was significant for transient ischemic attack, fatal stroke, nonfatal stroke and total stroke. There were insufficient data to compare individual agents. Conclusion: Antihypertensive treatment is associated with a significant reduction in stroke in elderly individuals. Reductions in dementia and cognitive decline were not significant; however, there was short follow-up. Comparative effectiveness evidence is limited.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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