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Titolo:
Benefits of treating hypertension in the elderly - Should age affect treatment decisions?
Autore:
Duggan, J;
Indirizzi:
Mater Misericordiae Hosp, Dublin 7, Ireland Mater Misericordiae Hosp Dublin Ireland 7 ordiae Hosp, Dublin 7, Ireland
Titolo Testata:
DRUGS & AGING
fascicolo: 9, volume: 18, anno: 2001,
pagine: 631 - 638
SICI:
1170-229X(2001)18:9<631:BOTHIT>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
OPTIMAL TREATMENT HOT; HIGH BLOOD-PRESSURE; RANDOMIZED TRIAL; CARDIOVASCULAR MORTALITY; 1.5 MG; ANTIHYPERTENSIVE THERAPY; SWEDISH TRIAL; OLD PATIENTS; INDAPAMIDE; MORBIDITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Duggan, J Mater Misericordiae Hosp, Eccles St, Dublin 7, Ireland Mater Misericordiae Hosp Eccles St Dublin Ireland 7 7, Ireland
Citazione:
J. Duggan, "Benefits of treating hypertension in the elderly - Should age affect treatment decisions?", DRUG AGING, 18(9), 2001, pp. 631-638

Abstract

Do the benefits of treating hypertension extend equally to all age groups,particularly the very elderly? Several large controlled trials have been published in recent years that confirm the benefits of the treatment of hypertension in terms of morbidity and mortality. However, these trials included only relatively small numbers of patients aged greater than or equal to 80 years. Data regarding such patients have been extracted and subjected to meta-analysis, but with inconclusive results. Further difficulties arise asa result of the range of therapeutic agents employed. Therefore, uncertainty still surrounds the value of treating very elderly patients with hypertension. The J-curve hypothesis, i.e. that a blood pressure threshold exists below which there is an increase in the rate of cardiac events, has been a concern in treating elderly patients. Upon close examination, this appears to be spurious. The Hypertension in the Very Elderly Trial study sets out to provide conclusive evidence for the benefits or otherwise of treating hypertension in the very elderly and has just commenced. The results of this trial will not be available for some time. In the meantime, should physicians initiate or continue treatment for very elderly individuals with hypertension? If so, what regimens should be employed and should target blood pressure levels be set? At the present time, it would appear sensible to provide treatment for very elderly patients with hypertension, particularly those with evidence of complications or target organ damage. In relatively healthy individuals withmild-to-moderate hypertension, the guiding principle should be 'the lower the blood pressure the better'. Regarding the choice of therapeutic agent, a low-dose diuretic remains the first choice therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/01/20 alle ore 09:39:06