#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Treatment of arterial hypertension in the elderly


Authors: L. Jelínek;  J. Václavík
Authors‘ workplace: I. interní klinika –  kardiologická FN Olomouc, Olomouc
Published in: Kardiol Rev Int Med 2018, 20(1): 17-21

Overview

Arterial hypertension is one of the most important cardiovascular risk factors. Results of the HYVET and recent SPRINT clinical trials brought plenty of evidence that the treatment of hypertension in older patients is beneficial. Also patients with isolated systolic hypertension benefit from treatment. Specific methods of blood pressure reduction are find­ing their way into guidelines and we incorporate them into our daily practice, taking into account the patient’s clinical status. One current trend in treating the elderly, as well as other hypertensive patients, is the use of fixed single-pill combinations.

Key words:
arterial hypertension –  old age –  heart failure –  adherence to treatment –  diuretic –  ACE inhibitors –  stroke


Sources

1. Lawes CM, Vander Hoorn S, Law MR et al. Blood pres­sure and the global burden of dis­ease 2000. Part II: estimates of attributable burden. J Hypertens 2006; 24(3): 423– 430.

2. ALLHAT Of­ficers and Coordinatorsforthe ALLHAT Col­laborativeResearch Group. The Antihypertensive and Lipid-LoweringTreatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensivepatientsrandomized to angiotensin-convert­­ing enzyme inhibitor orcalciumchan­nelblockervsdiuretic: The Antihypertensive and Lipid-Lower­­ing Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002; 288(23): 2981– 2997.

3. Law MR, Mor­ris JK, Wald NJ. Use of blood pres­sure lower­­ing drugs in the prevention of cardiovascular dis­ease: meta-analysis of 147 randomised trials in the kontext of expectations from prospective epidemiological studies. BMJ 2009; 338: b1665. doi: 10.1136/ bmj.b1665.

4. Zdravotnická ročenka ČR 2016. Dostupné na: http: / / www.uzis.cz/ system/ files/ zdr­roccz2016.pdf.

5. Beckett NS, Peters R, Fletcher AE et al. HYVET Study Group. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358(18): 1887– 1898. doi: 10.1056/ NEJMoa0801369.

6. Skoog I. Antihypertensive treatment and dementia prevention. Lancet Neurol 2008; 7(8): 664– 665. doi: 10.1016/ S1474-4422(08)70144-3.

7. PROGRESS Col­laborative Group. Randomised trial of a perindopril-based blood-pres­sure-lower­­ing regimen among 6,105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358(9287): 1033– 1041.

8. Kostis JB. Treat­­ing hypertension in the very old. N Engl J Med 2008; 358(18): 1958– 1960. doi: 10.1056/ NEJMe0801709.

9. Benetos A, Labat C, Ros­signol P et al. Treatment with multiple blood pres­sure medications, achieved blood pres­sure, and mortality in older nurs­­ing home residents: The PARTAGE Study. JAMA Intern Med 2015; 175(6): 989– 995. doi: 10.1001/ jamainternmed.2014.8012.

10. Mancia G et al. Arterial Hypertension (Management of): ESC Clinical Practice Guidelines 2013. Available at: https: / / www.escardio.org/ Guidelines/ Clinical-Practice-Guidelines/ Arterial-Hypertension-Management-of.

11. Wil­liamson JD, Supiano MA, Applegate WB et al. SPRINT Research Group. Intensivevs standard blood pres­sure control and cardiovascular dis­ease outcomes in adults aged ≥75 years: a randomized clinical trial. JAMA 2016; 315(24): 2673– 2682. doi: 10.1001/ jama.2016.7050.

12. A randomized trial of intensive versus standard blood-pres­sure control. N Engl J Med 2017; 377(25): 2506. doi: 10.1056/ NEJMx170008.

13. Franklin SS, Jacobs MJ, Wong ND et al. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analy­sis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001; 37(3): 869– 874.

14. Franklin SS, Larson MG, Khan SA et al. Does the relation of blood pres­sure to coronary heart dis­ease risk chase with aging? The Framingham Heart Study. Circulation 2001; 103(9): 1245– 1249.

15. Kang YY, Wang JG. The J-curve phenomenon in hypertension. Pulse 2016; 4(1): 49– 60. doi: 10.1159/ 000446922.

16. Treatment of hypertension in older adults, particularly isolated systolic hypertension. Up To Date 2017. Available at: https:/ / www.uptodate.com/ contents/ treatment-of-hypertension-in-older-adults-particularly-isolated-systolic-hyper-tension.

17. Burt VL, Whelton P, Roccel­la EJ et al. Prevalence ofhypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988– 1991. Hypertension 1995; 25(3): 305– 313.

18. Turnbull F, Neal B, Ninomiya T et al. Blood Pres­sure Lower­­ing Treatment Trialists' Col­laboration. Ef­fectsof dif­ferentr egimens to lower blood pres­sure on major cardiovascular events in older and younger adults: meta-analysis of rando­mised trials. BMJ 2008; 336(7653): 1121– 1123. doi: 10.1136/ bmj.39548.738368.BE.

19. Lindholm LH, Carlberg B, Samuels­son O. Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analy­sis. Lancet 2005; 366(9496): 1545– 1553. doi: 10.1016/ S0140-6736(05)67573-3.

20. Jamerson K, Weber MA, Bakris GL et al. ACCOMPLISH Trial Investigators. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008; 359(23): 2417– 2428. doi: 10.1056/ NEJMoa0806182.

21. Gangavati A, Hajjar I, Quach L et al. Hypertension, orthostatic hypotension, and the risk of­fal­ls in a com­munity-dwel­l­­ing elderly population: the maintenance of balance, independent living, intel­lect, and zest in the elderly of Boston study. J Am Geriatr Soc 2011; 59(3): 383– 389. doi: 10.1111/ j.1532-5415.2011.03317.x.

22. Figueora JJ, Basford JR, Low PA. Prevent­­ing and treat­­ing orthostatic hypotension: As easy as A, B, C. Cleve Clin J Mede 2010; 77(5): 298– 306. doi: 10.3949/ ccjm.77a.09118.

23. Fedorowski A, Stavenow L, Hedblad B et al. Orthostatic hypotension predicts al­l-cause mortality and coronary events in middle-aged individuals (The Malmö Preventive Project). Eur Heart J 2010; 31(1): 85– 91. doi: 10.1093/ eurheartj/ ehp329.

Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology

Article was published in

Cardiology Review

Issue 1

2018 Issue 1

Most read in this issue
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#