Hypertension treatment for older people-navigating between Scylla and Charybdis

Age and Ageing

Volumn 47, Issue 4, 2018, Pages 505-508

  Conroy, Simon Paul ^d   Westendorp, Rudi Gerardus Johannes ^a,b   Witham, Miles D ^c  

^a UNIVERSITY OF COPENHAGEN   (Denmark)

^b LEIDEN UNIVERSITY MEDICAL CENTER   (Netherlands)

^c UNIVERSITY OF DUNDEE   (United Kingdom)

^d UNIVERSITY OF LEICESTER   (United Kingdom)

Author keywords

Frailty; Hypertension; Older people

Indexed keywords

ANTIHYPERTENSIVE AGENT;

AGING; BLOOD PRESSURE REGULATION; CARDIOVASCULAR MORTALITY; CARDIOVASCULAR RISK; DEMENTIA; DRUG EFFICACY; EVIDENCE BASED MEDICINE; FRAILTY; HUMAN; HYPERTENSION; MEDICAL DECISION MAKING; PRACTICE GUIDELINE; PRIORITY JOURNAL; REVIEW; AGE; AGED; BLOOD PRESSURE; CLINICAL DECISION MAKING; COMORBIDITY; DRUG EFFECT; GERIATRIC ASSESSMENT; PATHOPHYSIOLOGY; RISK FACTOR; TREATMENT OUTCOME; VERY ELDERLY;

AGE FACTORS; AGED; AGED, 80 AND OVER; AGING; ANTIHYPERTENSIVE AGENTS; BLOOD PRESSURE; CLINICAL DECISION-MAKING; COMORBIDITY; GERIATRIC ASSESSMENT; HUMANS; HYPERTENSION; RISK FACTORS; TREATMENT OUTCOME;

EID: 85050098842     PISSN: 00020729     EISSN: 14682834     Source Type: Journal    
DOI: 10.1093/ageing/afy053     Document Type: Review

References (23)

1. Krause T, Lovibond K, Caulfield M, McCormack T, Williams B. Management of hypertension: summary of NICE guidance. Br Med J 2011; 343: d4891.
2. Musini VM, Tejani AM, Bassett K, Wright JM. Pharmaco-therapy for hypertension in the elderly. Cochrane Database Syst Rev 2009; Cd000028.
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). J Am Med Assoc 2014; 311: 507-20.
4. Birkenhager WH, Forette F, Staessen JA. Dementia and antihypertensive treatment. Curr Opin Nephrol Hypertens 2004; 13: 225-30.
5. Ravindrarajah R, Hazra NC, Hamada S et al. Systolic blood pressure trajectory, frailty and all-cause mortality over 80 years of age. Cohort study using electronic health records. Circulation 2017; 135: 2357-68.
6. Delgado J, Masoli JAH, Bowman K et al. Outcomes of treated hypertension at age 80 and older: cohort analysis of 79,376 individuals. J Am Geriatr Soc 2017; 65: 995-1003. doi:10.1111/jgs.14712.
7. Messerli FH, Mancia G, Conti CR et al. Dogma disputed: can aggressively lowering blood pressure in hypertensive patients with coronary artery disease be dangerous? Ann Intern Med 2006; 144: 884-93.
8. Garrison SR, Kolber MR, Korownyk CS, McCracken RK, Heran BS, Allan GM. Blood pressure targets for hypertension in older adults. Cochrane Database Syst Rev 2017; 8: CD011575. doi:10.1002/14651858.CD011575.pub2.
9. Lonn EM, Bosch J, Lopez-Jaramillo P et al. Blood-pressure lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med 2016; 374: 2009-20.
10. SPRINT Research Group. Wright JT Jr, Williamson JD, Whelton PK et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373: 2103-16.
11. Tinetti ME. Preventing falls in elderly persons. N Engl J Med 2003; 348: 42-9.
12. Tadic M, Cuspidi C, Hering D. Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden. BMC Cardiovasc Disord 2016; 16: 208.
13. Qiu C, von Strauss E, Fastbom J, Winblad B, Fratiglioni L. Low blood pressure and risk of dementia in the Kungsholmen project: a 6-year follow-up study. Arch Neurol 2003; 60: 223-8.
14. van Beek AH, Sijbesma JC, Jansen RW, Rikkert MG, Claassen JA. Cortical oxygen supply during postural hypotension is further decreased in Alzheimer's disease, but unrelated to cholinesterase-inhibitor use. J Alzheimers Dis 2010; 21: 519-26.
15. 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: 1887-98.
16. Warwick J, Falaschetti E, Rockwood K et al. No evidence that frailty modifies the positive impact of antihypertensive treatment in very elderly people: an investigation of the impact of frailty upon treatment effect in the HYpertension in the Very Elderly Trial (HYVET) study, a double-blind, placebo-controlled study of antihypertensives in people with hypertension aged 80 and over. BMC Med 2015; 13: 78. doi:10.1186/s12916-015-0328-1.
17. 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. J Am Med Assoc 2016; 315: 2673-82. doi:10.1001/jama.2016.7050.
18. National Institute for Health and Clinical Excellence. Hypertension: Management of Hypertension in Adults in Primary Care. London: National Institute for Clinical Excellence, 2006.
19. Mukete BN, Ferdinand KC. Polypharmacy in older adults with hypertension: a comprehensive review. J Clin Hypertens 2016; 18: 10-8.
20. Wilson M, Mair A, Dreischulte T, Witham MD. Prescribing to fit the needs of older people-the NHS Scotland Polypharmacy Guidance, 2nd edition. J R Coll Physicians Edinb 2015; 45: 108-13. doi:10.4997/JRCPE.2015.204.
21. Clegg A, Relton C, Young J, Witham M. Improving recruitment of older people to clinical trials: use of the cohort multiple randomised controlled trial design. Age Ageing 2015; 44: 547-50. doi:10.1093/ageing/afv044.
22. McCormack J. Blood Pressure Medicines for Five Years to Prevent Death, Heart Attacks, and Strokes. The NNT. 2014 [cited 2015 11 December]. http://www.thennt.com/nnt/antihypertensives-to-prevent-death-heart-attacks-and-strokes/
23. Kostis JB, Davis BR, Cutler J et al. Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group. J Am Med Assoc 1997; 278: 212-6.