Blood Pressure Management In Frail Older People a The Real World Experience

α
naschitz
naschitz
σ
Prof. Jochanan E. Naschitz
Prof. Jochanan E. Naschitz

Send Message

To: Author

Blood Pressure Management In Frail Older People a The Real World Experience

Article Fingerprint

ReserarchID

368BD

Blood Pressure Management In Frail Older People a The Real World Experience Banner

AI TAKEAWAY

Connecting with the Eternal Ground
  • English
  • Afrikaans
  • Albanian
  • Amharic
  • Arabic
  • Armenian
  • Azerbaijani
  • Basque
  • Belarusian
  • Bengali
  • Bosnian
  • Bulgarian
  • Catalan
  • Cebuano
  • Chichewa
  • Chinese (Simplified)
  • Chinese (Traditional)
  • Corsican
  • Croatian
  • Czech
  • Danish
  • Dutch
  • Esperanto
  • Estonian
  • Filipino
  • Finnish
  • French
  • Frisian
  • Galician
  • Georgian
  • German
  • Greek
  • Gujarati
  • Haitian Creole
  • Hausa
  • Hawaiian
  • Hebrew
  • Hindi
  • Hmong
  • Hungarian
  • Icelandic
  • Igbo
  • Indonesian
  • Irish
  • Italian
  • Japanese
  • Javanese
  • Kannada
  • Kazakh
  • Khmer
  • Korean
  • Kurdish (Kurmanji)
  • Kyrgyz
  • Lao
  • Latin
  • Latvian
  • Lithuanian
  • Luxembourgish
  • Macedonian
  • Malagasy
  • Malay
  • Malayalam
  • Maltese
  • Maori
  • Marathi
  • Mongolian
  • Myanmar (Burmese)
  • Nepali
  • Norwegian
  • Pashto
  • Persian
  • Polish
  • Portuguese
  • Punjabi
  • Romanian
  • Russian
  • Samoan
  • Scots Gaelic
  • Serbian
  • Sesotho
  • Shona
  • Sindhi
  • Sinhala
  • Slovak
  • Slovenian
  • Somali
  • Spanish
  • Sundanese
  • Swahili
  • Swedish
  • Tajik
  • Tamil
  • Telugu
  • Thai
  • Turkish
  • Ukrainian
  • Urdu
  • Uzbek
  • Vietnamese
  • Welsh
  • Xhosa
  • Yiddish
  • Yoruba
  • Zulu

Abstract

According to recent evidence, blood pressure (BP) management benefits the same patients with mild frailty and fit subjects. In contrast, there is no evidence that antihypertensive treatment benefits patients with severe frailty, yet much evidence that such treatment is not safe.Notably, comorbidities can impact on benefits and harms of BP treatment. For enabling patient management based on individualized expected outcomes, there is a need to substantially increase observational data, focused on complex clinical situations and various comorbidities. In line with this aim, we present our experience from the perspective of longterm geriatric care. It is hoped that observations from the bedside, enhanced and expanded in the future, might contribute to the shift from empirical practice towards an evidencebalanced approach.

References

63 Cites in Article
  1. S Lewington,R Clarke,N Qizilbash,R Peto,R Collins (2002). Prospective Studies Collaboration. Agespecific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.
  2. Jane Warwick,Emanuela Falaschetti,Kenneth Rockwood,Arnold Mitnitski,Lutgarde Thijs,Nigel Beckett,Christopher Bulpitt,Ruth Peters (2015). No evidence that frailty modifies the positive impact of antihypertensive treatment in very elderly people: an investigation of the impact of frailty upon treatment effect in the HYpertension in the Very Elderly Trial (HYVET) study, a double-blind, placebo-controlled study of antihypertensives in people with hypertension aged 80 and over.
  3. Sprint Research,Group,J Wright,J Williamson,P Whelton (2015). A Randomized Trial of Intensive versus Standard Blood-Pressure Control.
  4. G Howard,M Banach,M Cushman,D Goff,V Howard,D Lackland,J Mcvay,J Meschia,P Muntner,S Oparil,M Rightmyer,H Taylor (2015). Is blood pressure control for stroke prevention the correct goal? The lost opportunity of preventing hypertension.
  5. Franz Messerli,Sripal Bangalore,Adrian Messerli (2018). Age, Blood Pressure Targets, and Guidelines.
  6. Barry Materson,Manuel Garcia-Estrada,Richard Preston (2016). Hypertension in the frail elderly.
  7. M Muller,Y Smulders,P De Leeuw (2014). Treatment of hypertension in the oldest old: a critical role for frailty?.
  8. Acc/ (2017). AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/ NMA/PCNA Guideline for the prevention, detection, ealuation, and management of high blood pressure in adults. A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
  9. Jochanan Naschitz,Itzhak Rosner (2007). Orthostatic hypotension: framework of the syndrome.
  10. Martin Myers (2016). A Short History of Automated Office Blood Pressure – 15 Years to <scp>SPRINT</scp>.
  11. George Bakris (2016). The Implications of Blood Pressure Measurement Methods on Treatment Targets for Blood Pressure.
  12. E Mossello,M Pieraccioli,S Zanieri (2012). Ambulatory blood pressure monitoring in older nursing home residents: diagnostic and prognostic role.
  13. Norm Campbell,Adel Berbari,Lyne Cloutier,Mark Gelfer,John Kenerson,Tej Khalsa,Daniel Lackland,Daniel Lemogoum,Birinder Mangat,Sailesh Mohan,Martin Myers,Mark Niebylski,Eoin O'brien,George Stergiou,Eugenia Veiga,Xin‐hua Zhang (2014). Policy Statement of the World Hypertension League on Noninvasive Blood Pressure Measurement Devices and Blood Pressure Measurement in the Clinical or Community Setting.
  14. J Naschitz,G Slobodin,N Elias,I Rosner (2006). The patient with supine hypertension and orthostatic hypotension: a clinical dilemma.
  15. Gaynor Brewer,L Mellon,L Hall,P Horgan,F Shelley,E Dolan,E Hickey,A Bennett,K Williams,D (2017). Interarm blood pressure difference in a poststroke population.
  16. E O'brien,G Parati,G Stergiou (2013). What is the international consensus?.
  17. Bodil Weidung,Annika Toots,Peter Nordström,Bo Carlberg,Yngve Gustafson (2017). Systolic blood pressure decline in very old individuals is explained by deteriorating health.
  18. George Bakris,Matthew Sorrentino (2018). Redefining Hypertension — Assessing the New Blood-Pressure Guidelines.
  19. Ivan Aprahamian,Eduardo Sassaki,Marília Dos Santos,Rafael Izbicki,Rafael Pulgrossi,Marina Biella,Ana Borges,Marcela Sassaki,Leonardo Torres,Ícaro Fernandez,Olívia Pião,Paula Castro,Pedro Fontenele,Mônica Yassuda (2017). Hypertension and frailty in older adults.
  20. Min-Gu Kang,Sun-Wook Kim,Sol-Ji Yoon,Jung-Yeon Choi,Kwang-Il Kim,Cheol-Ho Kim (2017). Association between Frailty and Hypertension Prevalence, Treatment, and Control in the Elderly Korean Population.
  21. K Bailey,B Grossardt,J Graves (2008). Novel use of Kaplan-Meier methods to explain age and gender differences in hypertension control rates.
  22. Paul Muntner,Emily Levitan,Amy Lynch,Lara Simpson,Jeffrey Whittle,Barry Davis,John Kostis,Paul Whelton,Suzanne Oparil (2014). Effect of Chlorthalidone, Amlodipine, and Lisinopril on Visit‐to‐Visit Variability of Blood Pressure: Results From the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial.
  23. B Dahlöf,P Sever,N Poulter,H Wedel,D Beevers,M Caulfield,R Collins,S Kjeldsen,A Kristinsson,G Mcinnes,J Mehlsen,M Nieminen,E O'brien,J: Ascot Ostergren,Investigators (2005). Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial.
  24. R Poortvliet,S Lloyd,I Ford,N Sattar,A De Craen,L Wijsman (2015). Biological correlates of blood pressure variability in elderly at high risk of cardiovascular disease.
  25. Christopher Tsoi,Justin Chow,Kenny Choi,Hiu-Wah Li,Jason Nie,C Tracy,Li Wang,Ross Upshur (2014). Medical characteristics of the oldest old: retrospective chart review of patients aged 85+ in an academic primary care centre.
  26. Giuseppe Mancia,Guido Grassi (2014). Aggressive Blood Pressure Lowering Is Dangerous: The J-Curve.
  27. G Mancia,R Fagard,K Narkiewicz (2013). 2013 ESH/ESC GUIDELINES FOR THE MANAGEMENT OF ARTERIAL HYPERTENSION.
  28. Diana Cao,Rebecca Tran (2018). Considerations for Optimal Blood Pressure Goals in the Elderly Population: A Review of Emergent Evidence.
  29. S Bromfield,C Ngameni,L Colantonio (2017). Blood pressure, antihypertensive polypharmacy, frailty, and risk for serious fall injuries among older treated adults with hypertension.
  30. M Burstyn (2017). Hypertension, Its Treatment, Frailty, Falls, and Mortality.
  31. Giulia Ogliari,Rudi Westendorp,Majon Muller,Daniela Mari,Erminio Torresani,Irene Felicetta,Tiziano Lucchi,Paolo Rossi,Behnam Sabayan,Anton De Craen (2015). Blood pressure and 10-year mortality risk in the Milan Geriatrics 75+ Cohort Study: role of functional and cognitive status.
  32. Chang-Yang Xing,Takashi Tarumi,Rutger Meijers,Marcel Turner,Justin Repshas,Li Xiong,Kan Ding,Wanpen Vongpatanasin,Li-Jun Yuan,Rong Zhang (2017). Arterial Pressure, Heart Rate, and Cerebral Hemodynamics Across the Adult Life Span.
  33. Lauro Vianna,Shekhar Deo,Areum Jensen,Seth Holwerda,Matthew Zimmerman,Paul Fadel (2015). Impaired dynamic cerebral autoregulation at rest and during isometric exercise in type 2 diabetes patients.
  34. J Caldas,R Panerai,V Haunton,J Almeida,G Ferreira,L Camara,R Nogueira,E Bor-Seng-Shu,M Oliveira,R Groehs,L Ferreira-Santos,M Teixeira,F Galas,T Robinson,F Jatene,L Hajjar (2017). Cerebral blood flow autoregulation in ischemic heart failure.
  35. A Lagi,S Bacalli,S Cencetti,C Paggetti,L Colzi (1994). Cerebral autoregulation in orthostatic hypotension. A transcranial Doppler study..
  36. Carrie Goodson,Kathryn Rosenblatt,Lucia Rivera-Lara,Paul Nyquist,Charles Hogue (2018). Cerebral Blood Flow Autoregulation in Sepsis for the Intensivist: Why Its Monitoring May Be the Future of Individualized Care.
  37. Miguel Schwartz,J Naschitz,D Yeshurun (1990). Oral Nifedipine in the Treatment of Hypertensive Urgency: Cerebrovascular Accident Following a Single Dose.
  38. Oda-Christina Suter,Thanomphone Sunthorn,Rudolf Kraftsik,Joel Straubel,Pushpa Darekar,Kamel Khalili,Judith Miklossy (2002). Cerebral Hypoperfusion Generates Cortical Watershed Microinfarcts in Alzheimer Disease.
  39. H Hadi,S D'souza,M El-Omar (2012). Hypovolemiainduced severe coronary spasm leading to acute myocardial infarction.
  40. Roy Freeman,Wouter Wieling,Felicia Axelrod,David Benditt,Eduardo Benarroch,Italo Biaggioni,William Cheshire,Thomas Chelimsky,Pietro Cortelli,Christopher Gibbons,David Goldstein,Roger Hainsworth,Max Hilz,Giris Jacob,Horacio Kaufmann,Jens Jordan,Lewis Lipsitz,Benjamin Levine,Phillip Low,Christopher Mathias,Satish Raj,David Robertson,Paola Sandroni,Irwin Schatz,Ron Schondorff,Julian Stewart,J Van Dijk (2011). Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome.
  41. J Frith,J Newton,S Parry (2014). Measuring and defining orthostatic hypotension in the older person.
  42. A Scuteri,A Modestino,A Frattari,N Di Daniele,M Tesauro (2012). Occurrence of Hypotension in Older Participants. Which 24-hour ABPM Parameter Better Correlate With?.
  43. Vera Novak,Peter Novak,Judith Spies,Phillip Low (1998). Autoregulation of Cerebral Blood Flow in Orthostatic Hypotension.
  44. M Bengtsson-Lindberg,V Larsson,L Minthon (2015). Lack of orthostatic symptoms in de mentia patients with orthostatic hypotension.
  45. Hyung Lee,Phillip Low,Hyun Kim (2017). Patients with Orthostatic Intolerance: Relationship to Autonomic Function Tests results and Reproducibility of Symptoms on Tilt.
  46. Emi Oishi,Satoko Sakata,Takuya Tsuchihashi,Mitsuhiro Tominaga,Koji Fujii (2016). Orthostatic Hypotension Predicts a Poor Prognosis in Elderly People with Dementia.
  47. Michael Rockwood,Susan Howlett,Kenneth Rockwood (2012). Orthostatic hypotension (OH) and mortality in relation to age, blood pressure and frailty.
  48. Bromfield Ngameni,C Colantonio,L (2017). Blood pressure, antihypertensive polypharmacy, frailty, and risk for serious fall injuries among older treated adults with hypertension.
  49. R Jansen,L Lipsitz (1995). Postprandial hypotension: epidemiology, pathophysiology, and clinical management.
  50. L Vloet,R Pel-Little,P Jansen,R Jansen (2005). High prevalence of postprandial and orthostatic hypotension among geriatric patients admitted to Dutch hospitals.
  51. Jessica Barochiner,José Alfie,Lucas Aparicio,Paula Cuffaro,Marcelo Rada,Margarita Morales,Carlos Galarza,Marcos Marín,Gabriel Waisman (2014). Postprandial hypotension detected through home blood pressure monitoring: a frequent phenomenon in elderly hypertensive patients.
  52. J Carlson (1999). Assessment of orthostatic blood pressure. Measurement technique and clinical applications.
  53. Italo Biaggioni,Rose Robertson (2002). Hypertension in orthostatic hypotension and autonomic dysfunction.
  54. Avraham Weiss,Ehud Grossman,Yichayaou Beloosesky,Joseph Grinblat (2002). Orthostatic Hypotension in Acute Geriatric Ward.
  55. Rene Jansen,Lewis Lipsitz (1995). Postprandial Hypotension: Epidemiology, Pathophysiology, and Clinical Management.
  56. Kenneth Rockwood,Xiaowei Song,Chris Macknight,Howard Bergman,David Hogan,Ian Mcdowell,Arnold Mitnitski (2005). CSHA Frailty Index.
  57. Carrie Goodson,Kathryn Rosenblatt,Lucia Rivera-Lara,Paul Nyquist,Charles Hogue (2018). Cerebral Blood Flow Autoregulation in Sepsis for the Intensivist: Why Its Monitoring May Be the Future of Individualized Care.
  58. S O'callaghan,R Kenny (2016). Neuro cardiovascular instability and cognition.
  59. James Frith (2015). Diagnosing orthostatic hypotension: a narrative review of the evidence.
  60. Jeremy Sussman,Eve Kerr,Sameer Saini,Rob Holleman,Mandi Klamerus,Lillian Min,Sandeep Vijan,Timothy Hofer (2015). Rates of Deintensification of Blood Pressure and Glycemic Medication Treatment Based on Levels of Control and Life Expectancy in Older Patients With Diabetes Mellitus.
  61. R Cypreste,K Walsh,M Bedford (2015). Evidence-based medicine: what does the future hold?.
  62. Wee Lim,Y Ding (2015). Evidence-balanced Medicine: “Real” Evidence-based Medicine in the Elderly.
  63. Liana Fraenkel,T Fried (2010). Individualized Medical Decision Making.

Funding

No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

Ethical Approval

No ethics committee approval was required for this article type.

Data Availability

Not applicable for this article.

How to Cite This Article

naschitz. 2018. \u201cBlood Pressure Management In Frail Older People a The Real World Experience\u201d. Global Journal of Medical Research - F: Diseases GJMR-F Volume 18 (GJMR Volume 18 Issue F2): .

Download Citation

Journal Specifications

Crossref Journal DOI 10.17406/gjmra

Print ISSN 0975-5888

e-ISSN 2249-4618

Keywords
Classification
GJMR-F Classification: NLMC Code: WB 280
Version of record

v1.2

Issue date

August 6, 2018

Language
en
Experiance in AR

Explore published articles in an immersive Augmented Reality environment. Our platform converts research papers into interactive 3D books, allowing readers to view and interact with content using AR and VR compatible devices.

Read in 3D

Your published article is automatically converted into a realistic 3D book. Flip through pages and read research papers in a more engaging and interactive format.

Article Matrices
Total Views: 2957
Total Downloads: 1519
2026 Trends
Related Research

Published Article

According to recent evidence, blood pressure (BP) management benefits the same patients with mild frailty and fit subjects. In contrast, there is no evidence that antihypertensive treatment benefits patients with severe frailty, yet much evidence that such treatment is not safe.Notably, comorbidities can impact on benefits and harms of BP treatment. For enabling patient management based on individualized expected outcomes, there is a need to substantially increase observational data, focused on complex clinical situations and various comorbidities. In line with this aim, we present our experience from the perspective of longterm geriatric care. It is hoped that observations from the bedside, enhanced and expanded in the future, might contribute to the shift from empirical practice towards an evidencebalanced approach.

Our website is actively being updated, and changes may occur frequently. Please clear your browser cache if needed. For feedback or error reporting, please email [email protected]

Request Access

Please fill out the form below to request access to this research paper. Your request will be reviewed by the editorial or author team.
X

Quote and Order Details

Contact Person

Invoice Address

Notes or Comments

This is the heading

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

High-quality academic research articles on global topics and journals.

Blood Pressure Management In Frail Older People a The Real World Experience

Prof. Jochanan E. Naschitz
Prof. Jochanan E. Naschitz

Research Journals