Prévalence d’une sténose carotidienne chez le nonagénaire : résultats d’une enquête hospitalière [Prevalence of carotid artery stenosis in nonagenarians: Survey in a primary care hospital]

Details

Serval ID
serval:BIB_D008F4B0A11A
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Prévalence d’une sténose carotidienne chez le nonagénaire : résultats d’une enquête hospitalière [Prevalence of carotid artery stenosis in nonagenarians: Survey in a primary care hospital]
Journal
Annales de cardiologie et d'angeiologie
Author(s)
Bohlender J., Nussberger J., Ménard J., Bohlender B.
ISSN
1768-3181 (Electronic)
ISSN-L
0003-3928
Publication state
Published
Issued date
06/2017
Peer-reviewed
Oui
Volume
66
Number
3
Pages
130-134
Language
french
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Carotid artery stenosis increases with age and may cause brain ischemia if arterial hypotension occurs. We performed a monocentric pilot study to investigate its prevalence in the very elderly and to assess its potential influence on blood pressure (BP) goals during antihypertensive treatment.
All patients≥90 years of a primary care medical ward were prospectively included over 15 months. Ultrasound exams of the precerebral arteries were offered to all elderly patients for routine evaluation of their cardiovascular risk. Frequencies of stenosed common, internal and external carotid arteries (CCA, ICA, ECA) were analyzed together with clinical BP and antihypertensive therapy. Patients with circulatory shock and readmissions were excluded.
Sixty-three patients aged 92±3 years (78% female) hospitalized for a median of 11 days were included. On admission, 76% were on antihypertensive drugs vs. 86% at discharge. Mean admission BP was 149/77 vs. 129/72mmHg at discharge; systolic BP<140mmHg 36% vs 64% (P<0.05). Mean intima-media thickness (ACC, right/left) was 8.7/9.4mm. Prevalence of plaque or stenosis<60% was: CCA 19.0%, ICA 19.0%, ECA 31.7%, bulb 74.6%; of stenosis≥60%: CCA 0%, ICA 7.9%, ECA 19.0%, ICA bilateral 1.6% (unilateral occlusion 3.1%, no bilateral). Coincidence of systolic BP<120mmHg and ACI stenosis≥60% had a probability of 1-2%.
Concerning the risk of brain ischemia due to carotid artery stenosis, a BP goal<140mmHg should be safe for most nonagenarians. If individual BP goals are lower, searching for significant stenosis by ultrasound may be useful.
Keywords
Aged, Aged, 80 and over, Antihypertensive Agents/therapeutic use, Carotid Intima-Media Thickness, Carotid Stenosis/diagnostic imaging, Carotid Stenosis/epidemiology, Female, Humans, Hypertension/diagnosis, Hypertension/drug therapy, Hypertension/epidemiology, Male, Plaque, Atherosclerotic/diagnostic imaging, Prevalence, Prospective Studies, Switzerland/epidemiology, Ultrasonography, Artère carotide, Blood pressure, Brain, Carotid artery, Cerveau, Elderly, Hypotension, Ischemia, Ischémie, Nonagénaire, Pression artérielle, Stenosis, Sténose
Pubmed
Create date
06/06/2017 18:51
Last modification date
20/08/2019 15:50
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