Jsou cílové hodnoty pro léčbu arteriální hypertenze odlišné ve středním a vyšším věku?
Co říkají klinické studie, guidelines a jaká jsou současná doporučení pro klinickou praxi.

Czech version

Authors: Prof. MUDr. Eva Topinková, CSc.; MUDr. Marie Berková, Ph.D.; MUDr. Tomáš Richter
Authors‘ workplace: Geriatrická klinika 1. LF UK a VFN, Praha
Published in: Geriatrie a Gerontologie 2014, 3, č. 1: 12-17
Category: Review Article

Overview

Hypertension is the most common cardiovascular disease in old age, associated with increased risk of cardiovascular and cerebrovascular complications. There is no doubt that efficient treatment achieving target blood pressure values <140/80 mmHg in the 40s-50s age group significantly reduces the rates of negative outcomes such as strokes, cardiovascular events, overall and cardiovascular mortality. Much less evidence is available for treatment of older patients, 65 years older or for very old patients, aged 80 years and more. Some studies even suggest that with more aggressive treatment, with SBP levels of 135 mmHg and below, mortality not only does not decline but it is in fact increasing (J or U shape mortality curves). Lack of consistent evidence is reflected in current American, European and Czech guidelines, with differing target blood pressure values for seniors. In clinical practice the target values thus differ between individual clinicians. In the article we review results of studies published so far on efficacy of hypertension treatment and discuss recommendations for optimal hypertension control in seniors in daily practice.

Key words:
arterial hypertension – isolated systolic hypertension – old age – scientific evidence – target values

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