Clinical and pharmacological management of hypertension in older patients
Article Sidebar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Main Article Content
Abstract
The article is presented the review of published sources devoted the strategy of treatment the older patients with hypertension according to the geriatric symptoms and syndromes. The definition of orthostatic and postprandial hypotension, hypotension-hypertension syndrome is shown. Based on the analyses of publication are taken the data related to prevalence, prognostic meaning, clinical outcomes of frailty in older people. The influence of geriatric signs on cardiovascular risk is pointed out. The discussion questions of the association between administration of medications and orthostatic hypertension in older patients are considered. The recommendations of optimal pharmacological management of hypertension in older patients into account of personification principles with assessment of aging changes and their dynamics during treatment are given.
Article Details
Keywords:
References
Ageing and life course. [www.who.int/ageing/age_friendly_cities/en/index.html
Judd E, Calhoun DA. Hypertension and orthostatіc hypotension in older patients. Hypertens. 2012;30(1):38-9. https://doi.org/10.1097/HJH.0b013e32834ed663
Vasbusa E, Labat C, Vivian ME, et al. Orthostatic hypotension in very old subjects living in nursing home: the PARTAGE study. J Hypertens. 2012;30:53-60. https://doi.org/10.1097/HJH.0b013e32834d3d73.
Pensato U, Strocchi E, Cortelli P, et al. Orthostatic hypotension and supine hypertension: a practical guide to diagnosis and management. G Ital Cardiol (Rome). 2021;22(1):42-52. https://doi.org/10.1714/3502.34882
Chisholm P, Anpalahan M. Orthostatic hypotension: pathophysiology, assessment, treatment and the paradox of supine hypertension. Intern Med J. 2017;47(4):370-9. https://doi.org/10.1111/imj.13171.
Naschitz JE, Slobodin G, Elias N, et al. The patient with supine hypertension and orthostatic hypotension: a clinical dilemma. Postgraduate Med J. 2006;82(966):246-53. https://doi.org/10.1136/pgmj.2005.037457
Luciano GL, Brennan MJ, Rothberg MB. Postprandial hypotension. Am J Med. 2010;123(3):281.e1-6. https://doi.org/10.1016/j.amjmed.2009.06.026.
Abbas R, Tanguy A, Bonnet-Zamponi D, et al. New simplified screening method for postprandial hypotension in older people. J Frailty Aging. 2018;7:28-33. https://doi.org/10.14283/jfa.2018.2
Kim MJ, Farrell J. Orthostatic hypotension: a practical approach. Am Fam Physician. 2022;1:39-49.
Van Orshoven NP, Jansen PA, Oudejans I, et al. Postprandial hypotension in clinical geriatric patients and healthy elderly: prevalence related to patient selection and diagnostic criteria. J Aging Res. 2010:243752:1-7 https://doi.org/10.4061/2010/243752
Jang A. Postprandial hypotension as a risk factor for the development of new cardiovascular disease: a prospective cohort study with 36 month follow-up in community-dwelling elderly people. J Clin Med. 2020;9:345. https://doi.org/10.3390/jcm9020345
Awosika A, Adabanya U, Millis RM, et al. Postprandial Hypotension: An Underreported Silent Killer in the Aged. Cureus, 2023; 15(2):e35411. https://doi.org/10.7759/cureus.35411
Morley JE, Vellas B, van Kan GA, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14:392-7. https://doi.org/10.1016/j.jamda.2013.03.022.
Buto MSS, Catai AM, Vassimon-Barroso V, et al. Baroreflex sensitivity in frailty syndrome. Braz J Med and Biolog Res. 2019;52(4):e8079. http://dx.doi.org/10.1590/1414-431X20198079
Flint K. Which came first, the frailty or the heart disease? Exploring the vicious cycle. J Am Coll Cardiol. 2015;65: 984-6. https://doi.org/10.1016/j.jacc.2014.12.042.
Clegg A, Young J, Iliffe S, et al. Frailty in elderly people. Lancet. 2013;381:752-62. https://doi.org/10.1016/S0140-6736(12)62167-9
Gangavati A, Hajjar I, Quach L, et al. Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. J Am Geriatr Soc. 2011;59(3):383-9. https://doi.org/10.1111/j.1532-5415.2011.03317.x.
Donnell DO, Romero-Ortuno R, Kennelly SP, et al. The «Bermuda Triangle» of orthostatic hypotension, cognitive impairment and reduced mobility: prospective associations with falls and fractures in The Irish Longitudinal Study on Ageing Age and Ageing. 2023;52:1-10. https://doi.org/10.1093/ageing/afad005
Fedorowski A, Engström G, Hedblad B, et al. Orthostatic hypotension predicts incidence of heart failure: the Malmö preventive project. Am J Hypertens. 2010;23(11):1209-15. https://doi.org/10.1038/ajh.2010.150.
Angelousi A, Girerd N, Benetos A, et al. Association between orthostatic hypotension and cardiovascular risk, cerebrovascular risk, cognitive decline and falls as well as overall mortality: a systematic review and meta-analysis. J Hypertens. 2014;32:1562-71; discussion 1571. https://doi.org/10.1097/HJH.
Odden M, Beilby P, Peralta C. Blood pressure in older adults: the importance of frailty. Curr Hypertens Rep. 2015;17:5539: 51-6.
Benetos A, Petrovic M, Timo Strandberg N. Hypertension Management in Older and Frail Older Patients. Circulation Res. 2019;124:1045-60. https://doi.org/10.1161/CIRCRESAHA.118.313236
Steenman M, Gilles Lande G. Cardiac aging and heart disease in humans. Biophys Rev. 2017;9:131-7. HTTPS://DOI.ORG/10.1007/s12551-017-0255-9
Keller KM, Howlett SE. Sex differences in the biology and pathology of the aging heart. Can J Cardiol 2016; 32:1065–1073. https://doi.org/10.1016/j.cjca.2016.03.017.
Ferrara N, Komici K, Corbi G, et al. Beta-adrenergic receptor responsiveness in aging heart and clinical implications. Front Physiol. 2014;4(396):1-10. https://doi.org/10.3389/fphys.2013.00396
Kamaruzzaman S, Watt H, Carson C, et al. The association between orthostatic hypotension and medication use in the British Women’s Heart and Health Study. Age Ageing 2010;39:51-6. HTTPS://DOI.ORG/10.1093/ageing/afp192
Juraschek SP, Taylor AA, Jackson T. Orthostatic Hypotension, Cardiovascular Outcomes, and Adverse Events Results From SPRINT. Hypertension. 2020;75:660-7. https://doi.org/10.1161/HYPERTENSIONAHA.119.14309
Szyndler A, Dereziński T, Wolf J, et al. Impact of orthostatic hypotension and antihypertensive drug treatment on total and cardiovascular mortality in a very elderly community-dwelling population. J Hypertension. 2019;37(2):331-8. HTTPS://DOI.ORG/10.1097/HJH.0000000000001878
Grobman B, Turkson-Ocran R-AN, Jan A, Staessen J, et al. Body Position and Orthostatic Hypotension in Hypertensive Adults: Results from the Syst-Eur Trial Randomized Controlled Trial. Hypertension. 2023;80(4):820-7. https://doi.org/10.1161/HYPERTENSIONAHA.122.20602.
Charlesworth C, Peralta C, Odden M. Functional status and antihypertensive therapy in older adults: a new perspective on old data. Am J Hypertens. 2016;29:690-5. https://doi.org/10.1093/ajh/hpv177
Warwick J, Falaschetti E, Rockwood K, et al. 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. BMC Med. 2015;13.78:2-8. https://doi.org/10.1186/s12916-015-0328-1
Poudel A, Hubbard R, Nissen L, Mitchell C. Frailty: a key indicator to minimize inappropriate medication in older people. QJM. 2013;106:969-75. https://doi.org/10.1093/qjmed/hct146
Ribeiro NB, Melo DO, Maia FOM, et al. Medication-related inpatient falls: a critical review. Braz J Pharm Sci. 2018;54(1).e17355:1-18. https://doi.org/10.1590/s2175-97902018000117355
Woolcott J, Richardson K, Wiens M, et al. Meta-analysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med. 2009;169:1952-60. https://doi.org/10.1001/archinternmed.2009.357.
Tinetti M, Han L, Lee D, et al. Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Intern Med. 2014;174:588-95. https://doi.org/10.1001/jamainternmed.2013.14764.
Butt D, Mamdani M, Austin P, et al. The risk of hip fracture after initiating antihypertensive drugs in the elderly. Arch Intern Med. 2012;172:1739-44. https://doi.org/10.1001/2013.jamainternmed.469
Zang G. Antihypertensive drugs and the risk of fall injuries: a systematic review and meta-analysis. J Int Med Res. 2013;41:1408-17. https://doi.org/10.1177/0300060513497562.
Ruths S, Bakken M, Ranhoff A, et al. Risk of hip fracture among older people using antihypertensive drugs: a nationwide cohort study. BMC Geriatr. 2015;15:153. https://doi.org/10.1186/s12877-015-0154-5.
Jonas M, Kazarski R, Chernin G. Ambulatory blood-pressure monitoring, antihypertensive therapy and the risk of fall injuries in elderly hypertensive patients. J Geriatr Cardiol. 2018 Apr;15(4):284-9. https://doi.org/10.11909/j.issn.1671-5411.2018.04.007.
Atirah Az-Zahra Abu Bakar, Azidah Abdul Kadir, Nur Suhaila Idris, et al. Older Adults with Hypertension: Prevalence of Falls and Their Associated Factors. Іnt J Environ Res Public Health. 2021 Aug 4;18(16):8257. https://doi.org/.3390/ijerph18168257.
Shobharani B, Swathi P. Role of Beta Blockers and associated fracture risk in Indian subjects with primary osteoporosis. Eur J Molecular and Clin Med. 2022;09(06):177-85.
Bokrantz T, Schioler L, Bostrom KB, et al. Antihypertensive drug classes and the risk of hip fracture: results from the Swedish primary care cardiovascular database. J Hypertens. 2020;38(1):167-75. HTTPS://DOI.ORG/10.1097/HJH.0000000000002245
Langerhuizen DWG, Verweij LPE, van der Wouden JC, et al. Antihypertensive drugs demonstrate varying levels of hip fracture risk: A systematic review and meta-analysis. Injury 2022;53(3):1098-107. https://doi.org/10.1016/j.injury.2021.09.036.