BMJ  2006;332:793-794 (1 April), doi:10.1136/bmj.332.7544.793-b

Letter

Blood pressure lowering in elderly patients with stroke

The first 150 words of the full text of this article appear below.

EDITOR—Mant et al say that the results of PROGRESS are not applicable to the stroke population in the community.¹ One reason cited is that patients in the community were 12 years older than those recruited to PROGRESS. The authors explain the dangers of aggressive blood pressure lowering for people older than 80 and recommend further urgent studies.

Guidance on blood pressure lowering in people older than 80 is still lacking,² but this is no reason to deprive this group of appropriate treatment. If, for example, a fit and active 81 year old woman has a minor stroke then it seems appropriate to treat hypertension aggressively. It may be unethical for this patient to be recruited to a placebo arm of a blood pressure lowering trial and be deprived of treatment that may prevent a stroke.

Credit: SHEILA TERRY/SPL

 

It is thus simply not possible to perform randomised controlled . . . [Full text of this article]

Walsall Manor Hospital NHS Trust, Walsall, West Midlands WS2 9PS
elliotepstein832@hotmail.com

Walsall Manor Hospital NHS Trust, Walsall, West Midlands WS2 9PS

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Relevant Article

Applicability to primary care of national clinical guidelines on blood pressure lowering for people with stroke: cross sectional study

Jonathan Mant, Richard J McManus, and Rachel Hare
BMJ 2006 332: 635-637. [Abstract] [Full Text] [PDF]