Screening and treatment of hypertension in older adults: less is more?

Détails

Ressource 1Télécharger: BIB_49B9F8E68210.pdf (851.40 [Ko])
Etat: Public
Version: Final published version
ID Serval
serval:BIB_49B9F8E68210
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Screening and treatment of hypertension in older adults: less is more?
Périodique
Public health reviews
Auteur(s)
Anker D., Santos-Eggimann B., Santschi V., Del Giovane C., Wolfson C., Streit S., Rodondi N., Chiolero A.
ISSN
0301-0422 (Print)
ISSN-L
0301-0422
Statut éditorial
Publié
Date de publication
2018
Peer-reviewed
Oui
Volume
39
Pages
26
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Résumé
Screening and treatment of hypertension is a cornerstone of cardiovascular disease (CVD) prevention. Hypertension causes a large proportion of cases of stroke, coronary heart disease, heart failure, and associated disability and is highly prevalent especially among older adults. On the one hand, there is robust evidence that screening and treatment of hypertension prevents CVD and decreases mortality in the middle-aged population. On the other hand, among older adults, observational studies have shown either positive, negative, or no correlation between blood pressure (BP) and cardiovascular outcomes. Furthermore, there is a lack of high quality evidence for a favorable harm-benefit balance of antihypertensive treatment among older adults, especially among the oldest-old (i.e., above the age of 80 years), because very few trials have been conducted in this population. The optimal target BP may be higher among older treated hypertensive patients than among middle-aged. In addition, among frail or multimorbid older individuals, a relatively low BP may be associated with worse outcomes, and antihypertensive treatment may cause more harm than benefit. To guide hypertension screening and treatment recommendations among older patients, additional studies are needed to determine the most efficient screening strategies, to evaluate the effect of lowering BP on CVD risk and on mortality, to determine the optimal target BP, and to better understand the relationship between BP, frailty, multimorbidity, and health outcomes.
Mots-clé
Frailty, Hypertension, Older adults, Screening
Pubmed
Open Access
Oui
Création de la notice
10/09/2018 8:26
Dernière modification de la notice
20/08/2019 13:57
Données d'usage