Клінічний та фармакологічний менеджмент гіпертонічної хвороби в осіб старших вікових груп

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O. M. Kovalyova

Анотація

Стаття містить огляд літературних джерел, присвячених стратегії лікування хворих старших вікових груп з гіпертонічною хворобою з урахуванням геріатричних симптомів та синдромів. Наведено визначення ортостатичної та постпрандіальної гіпотензії, синдрому гіпотензії-гіпертензії. На підставі аналізу публікацій представлено дані про розповсюдженість, прогностичну значущість, клінічні наслідки старечої астенії. Відзначено вплив кластера геріатричних симптомів на серцево-судинний ризик при старінні. Розглянуто дискусійні питання асоціації прийому медикаментозних засобів та ортостатичної гіпотензії у старих хворих. Подано рекомендації стосовно оптимального фармакологічного менеджменту гіпертонічної хвороби у хворих похилого та старечого віку на принципах персоніфікованого підходу з оцінкою індивідуальних вікових змін та їхньої динаміки в процесі лікування.

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Ключові слова:

гіпертонічна хвороба, пацієнти старших вікових груп, ортостатична гіпотензія, постпрандіальна гіпотензія, стареча астенія, антигіпертензивна терапія

Посилання

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.