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Abstract
Three double-blind Veterans Administration Cooperative Studies are reviewed to determine
age-related changes in response to antihypertensive agents. In the first study 312
patients received hydrochlorothiazide titrated from 25 to 100 mg twice daily to lower
diastolic blood pressure (BP) to <90 mm Hg. Of 121 patients aged 55 to 65 the decrease
in BP averaged ![Math Eq]()
mm Hg, while in the 191 patients younger than 55 the reduction averaged ![Math Eq]()
mm Hg (p < 0.001; p = 0.048, respectively). Both systolic and diastolic BP reductions
averaged significantly more in older whites; in older blacks it was systolic BP only.
An additional 298 patients received titrated doses of propranolol alone, in this group
there were no significant differences in BP response between younger patients and
patients aged 55 to 65 except in the subgroup of white patients older than 60, in
whom the systolic reduction was significantly less than in the younger patients.
mm Hg, while in the 191 patients younger than 55 the reduction averaged 
mm Hg (p < 0.001; p = 0.048, respectively). Both systolic and diastolic BP reductions
averaged significantly more in older whites; in older blacks it was systolic BP only.
An additional 298 patients received titrated doses of propranolol alone, in this group
there were no significant differences in BP response between younger patients and
patients aged 55 to 65 except in the subgroup of white patients older than 60, in
whom the systolic reduction was significantly less than in the younger patients.In a second study of bendroflumethiazide alone and with nadotol, systolic BP decreased
more in older than in younger patients but there was no agerelated reduction with
nadotol atone. In the third trial captopril was first given atone and later with hydrochlorothiazide.
There were no age-related differences with captopril alone, but after the addition
of hydrochlorothiazide there was a trend toward a greater antihypertensive response
in the patients aged 55 to 69. Thus, responsiveness of older patients varies with
the type of antihypertensive drug. Age appears to increase the antihypertensive response
to thlazide diuretics but not to β-adrenergic blocking drugs or to captopril.
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Article Info
Publication History
Accepted:
September 12,
1987
Received in revised form:
September 11,
1987
Received:
June 4,
1987
Identification
Copyright
© 1988 Published by Elsevier Inc.
