A Meta-analysis of Intensive and Standard Antihypertensive Safety in Elderly Hypertensive Patients

Abstract

Objective: To evaluate the effect of intensive and standard antihypertensive pressure on cardiovascular and cerebrovascular events, serious adverse events and all-cause deaths in elderly hypertensive patients. Methods: Pubmed, Embase, Cochrane, CNKI, Wanfang and CBM databases were searched. All of the included studies were the RCT trials. Relative risk (RR) and 95% confidence interval (95%CI) were used to evaluate differences in enhanced and standard antihypertensive outcomes. Statistical analysis was applied using the Stata 17.0 software. Results: Seven tests were retrieved to meet the conditions, Different antihypertensive effects showed overall statistical differences in the incidence of cardiovascular and cerebrovascular events, Significant decrease in the intensive antihypertensive group [P=0.000, RR95%CI:0.79(0.69-0.90)], Among them, the incidence of acute myocardial infarction (AMI) and acute coronary syndrome (ACS) was significantly reduced in the intensive antihypertensive group [P=0.000, RR95%CI:0.62(0.48-0.81)], The incidence of stroke events was significantly fewer in the intensive group [P=0.000, RR95%CI:0.62(0.48-0.81)]; There was no significant difference in the incidence of acute HF (AHF) between the two groups [P=0.242, RR95%CI:0.55(0.20-1.50)]. There was no significant statistical difference in the incidence of serious adverse events overall by different antihypertensive criteria [P=0.251,RR95%CI:1.12(0.92-1.36)], of which two groups were eGFR<30ml/min/1.73m2There was no significant statistical difference in the incidence [P=0.280,RR95%CI:1.46(0.74-2.89)], no significant statistical difference in the incidence of orthostatic hypotension [P=0.473,RR95%CI:1.47(0.51-4.23)], no significant statistical difference in the incidence of falls [P=0.607,RR95%CI:1.24(0.54-42.86)], and the incidence of syncope in the intensive antihypertensive group was higher than that in the standard antihypertensive group [P=0.009,RR95%CI:2.43(1.24-4.77)]. There was no significant statistical difference in the effect of different antihypertensive criteria on all-cause death [P=0.156,RR95%CI:0.92(0.81-1.03)]. Conclusion: Compared with the standard antihypertensive in elderly patients with hypertension, there is no significant statistical difference in the incidence of serious adverse events and all-cause mortality in the elderly, and the incidence of cardiovascular and cerebrovascular events in the elderly.