In elderly patients (average age 70 years) a diastolic blood pressure DBP) less than 70 mm Hg was associated with increased non-cardiovascular (CV) mortality, while a DBP less than 50 mm Hg did not increase CV morbidity and mortality. These results were presented by°Dr. Robert Fagard°(Leuven, Belgium) at the 15th European Meeting of Hypertension in Milan, held from June 17-21, 2005.

These findings came from a further analysis of the Syst-Eur database to assess the relation between on-treatment DBP and outcomes in elderly patients with isolated systolic hypertension. The study patients had a sitting systolic blood pressure (SBP) of 160-219 mm Hg and a DBP < 95 mm Hg. The study drugs were nitrendipine with enalapril or hydroclorothiazide added as needed or placebo.

Of the 4039 active treatment patients, 490 died (248 were cardiovascular deaths) and 492 had a CV event in the 21,402 patient-years follow-up. In the placebo group, there were 129 deaths (66 CV) and 168 CV events in 5219 patient-years follow-up.

For the relative hazard ratio (RHR) calculated for 5 mm Hg categories of DBP, there was no difference in CV mortality or events whether the DBP was above or below the cut-off values. The RHR was 1.43 for a DBP less than 70 mm Hg for non-CV mortality in the active treatment group (p=0.02). There was a similar trend in the placebo group.