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A4669 Less-Tight versus tight control of hypertension in patients 80 years of age or older

Objectives: To assess the effects of less-tight control of hypertension (less than 150 to 160/95 to 105 mmHg) compared to tight control of hypertension (less than 140/90 mmHg) in the very old. Methods: Hypertensive patients aged ≥80 years in the South Building of Chinese PLA General Hospital in 2012 were included in this study. The included participants attended a structured clinical examination and an interview carried out by a geriatrician and trained nurses. A follow-up survey in 2017 was carried out on survivors in the same way as in 2012. Total mortality was measured as the main outcome. Secondary outcomes were coronary events, stroke, cardiovascular events, heart failure and cause-specific mortality. The common relative risk (RR) of tight controlled blood pressure (BP) versus less-tight controlled BP was assessed. Results: Included in the analysis were 2566 hypertensive patients 80 years of age or older. Satisfaction with blood-pressure care was high in both treatment groups, and we found no significant difference in adherence to blood-pressure medications. Treatment to the two different BP level over five years failed to produce a difference in any of our primary outcomes, including all-cause mortality (RR 1.24 95% CI 0.98 to 1.52), stroke (RR 1.27 95% CI 0.96 to 1.70) and total cardiovascular serious adverse events (RR 1.22 95% CI 0.99 to 1.55). However, the 95% CI of these outcomes suggest the less-tight control of BP level is probably not worse. Conclusion: The primary and second outcomes among patients who received tight control treatment were similar to those among patients who received less-tight control.