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Age-Dependent Differences in the Efficacy and Tolerability of Different Classes of Antihypertensive Drugs

Research paper by L. L. M. van de Ven

Indexed on: 28 Aug '12Published on: 28 Aug '12Published in: Clinical Drug Investigation



Abstract

The present study evaluated the age-related differences in antihypertensive response and drug-related adverse effects of 3 antihypertensive drugs from different classes in a younger and an older population of patients with mild to moderate essential hypertension. The β-blocker bisoprolol 5mg once daily, the diuretic bendrofluazide 2.5mg once daily or the calcium antagonist nifedipine retard 10mg twice daily were evaluated using double-blind techniques for antihypertensive efficacy, tolerability and influence on well-being. 154 patients (70 men, 84 women) were randomised; there were equal numbers (77) of younger and elderly patients. Adequate control of blood pressure (diastolic blood pressure < 95mm Hg) was achieved in a total of 96 (71.6%, CI: 63.8 to 79.4%) of the young and 114 (83.8%, CI: 77.6 to 90.0%) of the elderly patients when all 3 active treatment groups were included (p < 0.05). The response rate was significantly higher in the elderly. The response to low dosages was also significantly (p < 0.05) higher in the elderly (58.0%, CI 47.7 to 66.3%) than in the younger (50.0%, CI 41.6 to 58.4%) patients during active treatment. The general wellbeing was similar for all quality-of-life variables in both age groups during placebo phases and active treatment phases or between treatment groups. The control of high blood pressure can be achieved with antihypertensive drugs from different classes. Elderly people tend to respond better to antihypertensive monotherapy than younger patients. Adverse effects of the drug regimens did not influence the feeling of well-being in both age groups.