4. Antihypertensive drug therapy compared to control in adults 80 years or older with hypertension.
| Antihypertensive drug therapy compared to control in adults 80 years or older with hypertension | ||||||
| Patient or population: healthy ambulatory adults 80 years or older with hypertension Setting: outpatient Intervention: antihypertensive drug therapy Comparison: placebo or no treatment | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) |
Relative effect
(95% CI) Random‐effects model |
No. of participants (studies) |
Certainty of the evidence (GRADE) |
Comments | |
| Risk with control |
Risk with antihypertensive drug therapy |
|||||
| Total mortality Mean duration of 2.3 years |
142 per 1000 | 138 per 1000 (124 to 157) |
RR 0.97 (0.87 to 1.10) | 6701 (8 studies) | ⊕⊕⊝⊝ LOWa,b | Not significant |
| Cardiovascular mortality and morbidity Mean duration of 2.2 years |
115 per 1000 | 86 per 1000 (75 to 100) | RR 0.75 (0.65 to 0.87) | 6546 (7 studies) | ⊕⊕⊕⊝ MODERATEb | ARR = 2.9% NNTB = 35 |
| Cerebrovascular mortality and morbidity Mean duration of 2.2 years |
52 per 1000 | 35 per 1000 (27 to 43) | RR 0.66 (0.52 to 0.83) | 6546 (7 studies) | ⊕⊕⊕⊝ MODERATEb | ARR = 1.7% NNTB = 59 |
| Coronary heart disease mortality and morbidity Mean duration of 2.5 years |
21 per 1000 | 17 per 1000 (12 to 25) | RR 0.82 (0.56 to 1.20) | 5263 (6 studies) | ⊕⊕⊕⊝ MODERATEb | Not significant |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). ARR: absolute risk reduction; CI: confidence interval; NNTB: number needed to treat for an additional beneficial outcome; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
aDowngraded due to inconsistency and wide confidence interval.
bDowngraded due to study limitations ‐ high risk of selective reporting bias in HYVET 2008 study.