Treatment of hypertension in older patients

Česká verzia

Authors: M. Holická; J. Špinar
Authors place of work: Interní kardiologická klinika LF MU a FN Brno
Published in the journal: Kardiol Rev Int Med 2016, 18(4): 276-280

Summary

Prevalence hypertenze ve starší populaci je velmi vysoká. Velmi staří pacienti jsou často vylučováni z klinických studií. Cílem tohoto článku je shrnutí dosavadních znalostí farmakoterapie hypertenze starších pacientů. Na Interní kardiologické klinice FN Brno jsme vyhodnotili užívanou farmakoterapii hypertenze nemocných nad 90 let a srovnali s aktuálně platnými doporučeními. Pro tuto populaci (> 90 let) a křehké pacienty je stále málo medicínských důkazů.

Klíčové slova:
hypertenze – farmakoterapie – starší pacienti – antihypertenziva

Zdroje

1. Peters R, Beckett N, McCormack T et al. Treating hypertension in the very elderly-benefits, risks, and future directions, a focus on the hypertension in the very elderly trial. Eur Heart J 2014; 35(26): 1712– 1718. doi: 10.1093/ eurheartj/ eht464.

2. Appel LJ, Espeland MA, Easter L et al. Effects of reduced sodium intake on hypertension control in older individuals: results from the Trial of Nonpharmacologic Interventions in the Elderly (TONE). Arch Intern Med 2001; 161(5): 685– 693.

3. Xue QL. The frailty syndrome: definition and natural history. Clin Geriatr Med 2011; 27(1): 1– 15. doi: 10.1016/ j.cger.2010.08.009.

4. Franklin SS, Gustin W 4th, Wong ND et al. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation 1997; 96(1): 308– 315.

5. Franklin SS, Jacobs MJ, Wong ND et al. Predominance of isolated systolic hypertension among middleaged and elderly US hypertensives: Analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001; 37(3): 869– 874.

6. Young JH, Klag MJ, Muntner P et al. Blood pressure and decline in kidney function: findings from the Systolic Hypertension in the Elderly Program (SHEP). J Am Soc Nephrol 2002; 13(11): 2776– 2782.

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(12): 884– 893.

8. Vanhanen H, Thijs L, Birkenhäger W et al. Associations of orthostatic blood pressure fall in older patients with isolated systolic hypertension. Syst-Eur Investigators. J Hypertens 1996: 14(8): 943– 949.

9. 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(18): 1887– 1898. doi: 10.1056/ NEJMoa0801369.

10. 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. JAMA 2016; 315(24): 2673– 2682. doi: 10.1001/ jama.2016.7050.

11. 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). JAMA 2014; 311(5): 507– 520. doi: 10.1001/ jama.2013.284427.

12. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34(28): 2159– 2219. doi: 10.1093/ eurheartj/ eht151.

13. Filipovský J, Widimský J jr., Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze – verze 2012. Doporučení České společnosti pro hypertenzi. Hypertenze a kardiovaskulární prevence 2012; 3: 1– 16.