[Skip to Navigation]
Views 144
Citations 0
Comment & Response
April 2019

Older People Might Be at Most Serious Risk in Antihypertensive Treatment—Reply

Author Affiliations
  • 1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
  • 2Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
JAMA Intern Med. 2019;179(4):590-591. doi:10.1001/jamainternmed.2018.8619

In Reply We thank Tufan for highlighting the uncertainty relating to treatment of older patients with mild hypertension. In our study,1 we limited the analysis to patients younger than 75 years because our interest was in whether treatment was appropriate for low-risk patients. Our observational data were drawn from electronic health records from general practices in England and, as such, were representative of the population up to the age of 75 years, including presence of comorbidities. According to most clinical guidelines,2 patients 75 years or older should be considered at high risk of cardiovascular disease; hence, those patients were excluded from our study. In subgroup analyses, we did not find a difference between younger and older patients in the association between treatment and mortality or cardiovascular disease; however, these analyses may have been underpowered and, therefore, should be interpreted with caution.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words