Rosas-Peralta M, Borrayo-Sánchez G, Madrid-Miller A, Ramírez-Arias E, Pérez-Rodríguez G

Language: Spanish
References: 8
Page: 75-77
PDF size: 203.69 Kb.

ABSTRACT

Hypertension is common in people aged 65 and older. In those aged 70 and older, hypertension is more poorly controlled than in those whose age is between 60 and 69 years. The number of trials available concerning the elderly population is limited; therefore, strong recommendations on blood pressure (BP) goals are limited. The American College of Cardiology has recently published a consensus report of management of hypertension in the elderly population. This review presents an overview of that consensus report and reviews specific studies that provide some novel findings regarding BP goals and the progression of nephropathy. In general, the evidence strongly supports a BP goal ‹ 150/80 mm Hg for the elderly with scant data in those aged 80 and older. However, it was decided to set the goal ‹ 140/90 mm Hg, unless the patient cannot tolerate it, and then try to achieve 140-145 mm Hg. Diuretics and calcium antagonists are the most efficient treatment; however, most patients will require two or more drugs to achieve such goals.

REFERENCES

1. Oliva RV, Bakris GL. Management of Hypertension in the Elderly Population. J Gerontol A Biol Sci Med Sci. 2012;67(12):1343-51.

2. Banegas JR, Navarro-Vidal B, Ruilope LM, de la Cruz JJ, López-García E, Rodríguez-Artalejo F, et al. Trends in Hypertension Control Among the Older Population of Spain From 2000 to 2001 to 2008 to 2010. Circulation Cardiovascular Quality and Outcomes. 2015;8:67-76.

3. Franklin SS. Arterial Stiffness: Is It Ready for Prime Time? Curr Cardiol Rep. 2007;9:462-9.

4. Inoue R, Ohkubo T, Kikuya M, Metoki M, Asayama K, Obara T, et al. Stroke risk in systolic and combined systolic and diastolic hypertension determined using ambulatory blood pressure. The Ohasama Study. 2007;20:1125-31.

5. Fagard Rh, Staessen Ja, Thijs L, Celis H, Bulpitt Cj, De Leeuw Pw, et al. On treatment diastolic blood pressure and prognosis in systolic Hypertension. Arch Intern Med. 2007 Sep 24;167(17):1884-91.

6. Boutitie F, Gueyffier F, Pocock S, Fagard R, Boissel Jp: INDANA Project Steering Committee. INdividual Data ANalysis of Antihypertensive intervention. Jshaped relationship between blood pressure and mortality in hypertensive patients: new insights from a meta-analysis of individual-patient data. Ann Intern Med. 2002;136:438-48.

7. Fagard Rh, Van Den Enden M, Leeman M, Warling X: Survey on treatment of hypertension and implementation of WHO-ISH risk stratification in primary care in Belgium. J Hypertens. 2002;20:1297-302.

8. Lithell H, Hansson L, Skoog I, Elmfeldt D, Hofman A, Olofsson B, et al. SCOPE Study Group. The Study on Cognition and Prognosis in the Elderly (SCOPE). Principal results of a randomized double-blind intervention trial. J Hypertens. 2003;21: 875-86.