Outcomes of Treated Hypertension at Age 80 and Older: Cohort Analysis of 79,376 Individuals

Journal of the American Geriatrics Society

Volumn 65, Issue 5, 2017, Pages 995-1003

  Delgado, João ^a   Masoli, Jane A H ^a,b   Bowman, Kirsty ^a   Strain, W David ^a,b   Kuchel, George A ^c   Walters, Kate ^d   Lafortune, Louise ^e   Brayne, Carol ^e   Melzer, David ^a,c   Ble, Alessandro ^a  

^a UNIVERSITY OF EXETER MEDICAL SCHOOL   (United Kingdom)

^b ROYAL DEVON AND EXETER NHS FOUNDATION TRUST   (United Kingdom)

^c UNIVERSITY OF CONNECTICUT HEALTH CENTER   (United States)

^d UNIVERSITY COLLEGE LONDON   (United Kingdom)

^e UNIVERSITY OF CAMBRIDGE   (United Kingdom)

Author keywords

hypertension; mortality; oldest old; outcomes; primary care

Indexed keywords

ALPHA ADRENERGIC RECEPTOR BLOCKING AGENT; ANGIOTENSIN RECEPTOR ANTAGONIST; ANTIHYPERTENSIVE AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; RENIN INHIBITOR;

AGED; ANTIHYPERTENSIVE THERAPY; ARTICLE; CARDIOVASCULAR MORTALITY; CARDIOVASCULAR RISK; CEREBROVASCULAR ACCIDENT; COHORT ANALYSIS; DEATH CERTIFICATE; DIASTOLIC BLOOD PRESSURE; ENGLAND; FEMALE; FOLLOW UP; FRAGILITY FRACTURE; GENERAL PRACTICE; HEART FAILURE; HEART INFARCTION; HOSPITAL PATIENT; HUMAN; HYPERTENSION; MAJOR CLINICAL STUDY; MALE; PRIMARY MEDICAL CARE; SYSTOLIC BLOOD PRESSURE; TREATMENT OUTCOME; VERY ELDERLY; BLOOD PRESSURE; CARDIOVASCULAR DISEASES; MORTALITY; RISK FACTOR;

AGED, 80 AND OVER; ANTIHYPERTENSIVE AGENTS; BLOOD PRESSURE; CARDIOVASCULAR DISEASES; COHORT STUDIES; ENGLAND; FEMALE; HUMANS; HYPERTENSION; MALE; MORTALITY; RISK FACTORS;

EID: 85007490253     PISSN: 00028614     EISSN: 15325415     Source Type: Journal    
DOI: 10.1111/jgs.14712     Document Type: Article

References (29)

1. Melzer D, Tavakoly B, Winder RE et al. Much more medicine for the oldest old: Trends in UK electronic clinical records. Age Ageing 2015;44:46–53.
2. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013;34:2159–2219.
3. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311:507–520.
4. National Institute for Health and Care Excellence. Hypertension: Guidance and Guidelines. London, UK: National Institute for Health and Care Excellence, 2013.
5. Weber MA, Schiffrin EL, White WB et al. Clinical practice guidelines for the management of hypertension in the community: A statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens 2014;32:3–15.
6. Aronow WS, Fleg JL, Pepine CJ et al. ACCF/AHA 2011 expert consensus document on hypertension in the elderly. J Am Soc Hypertens 2011;5:259–352.
7. Chobanian AV. SPRINT results in older patients: How low to go? J Am Geriatr Soc 2016;315:2669–2670.
8. Herrett E, Gallagher AM, Bhaskaran K et al. Data resource profile: Clinical practice research datalink (CPRD). Int J Epidemiol 2015;44:827–836.
9. HSCIC. QOF Implementation Dataset and Business Rules - Hypertension (HYP) Indicator Set [Internet], 2013; 1–25. Available from: https://www.pcc-cic.org.uk/sites/default/files/articles/attachments/hypertension_ruleset_v25_1.pdf, Last accessed: 08 December 2016.
10. (WHO) WHO. ICD-10 Version:2015 [Internet]. 2015 [cited 2016 Dec 5]. Available from: http://apps.who.int/classifications/icd10/browse/2015/en Accessed December 08, 2016.
11. NHS. OPCS Classification of Interventions and Procedures [Internet]. NHS digital. 2016; 1. Available from: http://www.datadictionary.nhs.uk/web_site_content/supporting_information/clinical_coding/opcs_classification_of_interventions_and_procedures.asp Accessed December 08, 2016.
12. Khan NF, Perera R, Harper S et al. Adaptation and validation of the Charlson Index for Read/OXMIS coded databases. BMC Fam Pract 2010;11:1–7.
13. Schemper M. Cox analysis of survival data with non-proportional hazard functions. the Statistician 1992;41:455–465.
14. Schisterman EF, Cole SR, Platt R. Overadjustment bias and unnecessary adjustment in epidemiologic studies. Epidemiology 2009;20:488–495.
15. National Institute for Health and Care Excellence. Osteoporosis: Assessing the Risk of Fragility Fracture: Guidance and Guidelines. London, UK: National Institute for Health and Care Excellence, 2012.
16. Jason P, Fine RJG. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 1999;94:496–509.
17. Benetos A, Rossignol P, Cherubini A et al. Polypharmacy in the aging patient. JAMA 2015;314:170.
18. Altman DG, Andersen PK. Calculating the number needed to treat for trials where the outcome is time to an event. BMJ 1999;319:1492–1495.
19. Feldstein C, Weder AB. Orthostatic hypotension : A common, serious and underrecognized problem in hospitalized patients. J Am Soc Hypertens 2012;6:27–39.
20. Clarke R, Shipley M, Lewington S et al. Underestimation of risk associations due to regression dilution in long-term follow-up of prospective studies. Am J Epidemiol 1999;150:341–353.
21. Health and Social Care Information Centre. National Quality and Outcomes Framework Statistics for England—2004–05 [on-line]. Available at http://www.hscic.gov.uk/catalogue/PUB0194620 Accessed June 29, 2016.
22. Musini V, Tejani A, Bassett K et al. Pharmacotherapy for hypertension in the elderly. Cochrane Database Syst Rev 2009;4:CD000028.
23. Rapsomaniki E, Timmis A, George J et al. Blood pressure and incidence of twelve cardiovascular diseases: Lifetime risks, healthy life-years lost, and age-specific associations in 1·25 million people. Lancet 2014;383:1899–1911.
24. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903–1913.
25. Mancia G, Grassi G. Aggressive blood pressure lowering is dangerous: The J-curve: Pro side of the argument. Hypertension 2014;63:29–35.
26. Messerli FH. Dogma disputed: Can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous? Ann Intern Med 2006;144:884.
27. Panjrath GS, Chaudhari S, Messerli FH. The J-point phenomenon in aggressive therapy of hypertension: New insights. Curr Atheroscler Rep 2012;14:124–129.
28. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008;358:1887–1898.
29. Williamson JD, Supiano MA, Applegate WB et al. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥ 75 years: A randomized clinical trial. JAMA 2016;315:2673–2682.