Management of Hypertension in the Elderly and Frail Patient

Guasti, Luigina; Ambrosetti, Marco; Ferrari, Marco; Marino, Franca; Ferrini, Marc; Sudano, Isabella; Tanda, Maria Laura; Parrini, Iris; Asteggiano, Riccardo; Cosentino, Marco

doi:10.1007/s40266-022-00966-7

Cited by 27 publications

(12 citation statements)

References 109 publications

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“…In addition, evidence showed that frailty was closely associated with cardiovascular events. 16 Patients aged ≥65 years had higher NT-proBNP values, and a lower proportion of them achieved the target goal of LVEF (≥50%) in the present study. Similar to previous statistics, 17 the incidence of new or recurrent cardiovascular events was remarkably elevated among the elderly patients (≥65 years) compared with the others (<65 years).…”

Section: Discussioncontrasting

confidence: 53%

Influence of Aging on Outcomes of Sacubitril/Valsartan in Hypertensive Patients with Heart Failure: A Multicenter Retrospective Study

Zuo

2024

Anatol J Cardiol

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Background: The aim of this study was to investigate the influence of aging on the effectiveness and tolerance of sacubitril/valsartan (sac/val) among hypertensive patients complicated with heart failure in a real-world setting. Methods: This multicenter, retrospective study included patients (≥18 years old) admitted with a diagnosis of hypertension and heart failure, starting sac/val therapy between January 2020 and December 2021 from 3 medical centers. Patients were grouped by the cutoff age of 65 years. Outcomes were collected 31-365 days after the initiation of sac/val and were compared in a matched cohort after 1 : 1 propensity score matching (PSM). Results: A total of 794 patients were finally analyzed. Blood pressure and cardiac functions improved significantly compared with values at baseline. There were 269 patients in each cohort (<65 years and ≥65 years) after PSM. After PSM, the incidence of hyperuricemia and hypotension in the elderly patients (≥65 years) was significantly higher than in those <65 years of age. Kaplan–Meier estimate suggested that the cumulative incidence of new or recurrent cardiovascular events increased significantly at the age of ≥65 years after the point of 3 months (log-rank P = .00087). Conclusion: Sac/val benefited patients in both cohorts by improving blood pressure and cardiac function. Elderly patients (≥65 years) were susceptible to hypotension, low diastolic blood pressure, hyperuricemia, and underwent cardiac-related readmissions more frequently.

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Section: Discussioncontrasting

confidence: 53%

Influence of Aging on Outcomes of Sacubitril/Valsartan in Hypertensive Patients with Heart Failure: A Multicenter Retrospective Study

Zuo

2024

Anatol J Cardiol

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“…An exceedingly low BUN/Cr ratio indicates a state of hyperhydration, leading to an augmented cardiovascular preload and elevated blood pressure. Consequently, this escalation in cardiovascular strain heightens the susceptibility to heart failure and stroke ( 27 ). A diminished BUN/Cr ratio is correlated with heightened risks of total incident stroke and ischemic stroke ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Association between the blood urea nitrogen-to-creatinine ratio and 3-month outcomes in patients with acute ischemic stroke: a secondary analysis based on a prospective cohort study

Liu,

Chen,

Zhou

et al. 2024

Front. Neurol.

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IntroductionThis study aimed to assess the correlation between the blood urea nitrogen (BUN)-to-creatinine (BUN/Cr) ratio and adverse outcomes (AOs) at 3 months in patients with acute ischemic stroke (AIS) in the Korean population.MethodsThis cohort study encompassed 1906 cases of AIS at a South Korean hospital from January 2010 to December 2016. To determine the linear correlation between the BUN/Cr ratio and AOs in AIS, a binary logistic regression model (BLRM) was employed. Additionally, generalized additive models and techniques for smooth curve fitting were utilized to reveal the nonlinear dynamics between the BUN/Cr ratio and AOs in patients with AIS.ResultsThe prevalence of AOs was 28.65%, with a median BUN/Cr ratio of 18.96. Following adjustments for covariates, the BLRM disclosed that the association between the BUN/Cr ratio and the risk of AOs in patients with AIS did not attain statistical significance. Nevertheless, a nonlinear relationship surfaced, pinpointing an inflection point at 21.591. To the left of this inflection point, a 31.42% reduction in the risk of AOs was noted for every 1-unit surge in the Z score of the BUN/Cr ratio [odds ratio (OR) = 0.686, 95% confidence interval (CI): 0.519, 0.906, p = 0.008]. On the right side of the inflection point, the effect size (OR = 1.405, 95% CI: 1.018, 1.902, p = 0.039) was determined.ConclusionThe findings of this study underscore the intricate nature of the relationship between the BUN/Cr ratio and 3-month outcomes in patients with AIS, establishing a robust groundwork for future investigations.

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“…Di Indonesia sendiri, 23,7% dari 1,37 juta kematian di Indonesia pada tahun 2016 disebabkan oleh hipertensi. (Guasti et al, 2022;Kemenkes RI P2PTM, 2019;Shah & Stafford, 2017;Zhou et al, 2021) Bruno et al melaporkan adanya perubahan fisiologi pada pembuluh darah pada orang tua dan kontribusinya terhadap hipertensi. Hal ini membuat peneliti tertarik untuk mempelajari korelasi hipertensi dengan usia.…”

Section: Latar Belakangunclassified

Gambaran Tekanan Darah serta Korelasinya Terhadap Usia di Rukun Warga 008 Keluruhan Cipondoh Makmur

Frisca Frisca,

Alexander Halim Santoso,

William Gilbert Satyanagara

et al. 2023

JUFDIKES

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Introduction: Hypertension is one of the most common diseases in the world, and its increasing every year. Age is one of many risk factors in hypertension. As we get older, our blood vessels tend to lose some of their elasticity and become stiffer. This can put us at risk for developing high blood pressure, also known as hypertension. It's important to take care of our cardiovascular health as we age to reduce the risk of developing this condition.Purpose: To study the correlation between blood pressure and age.Method: This was a descriptive study conducted in Cipondoh Makmur, Tangerang. The non-random consecutive sampling was used as the sampling technique, and it will be presented as descriptive data. Spearman correlation tests were used to correlate blood pressure and age if the data distribution is not normal.Result: There were 103 individuals who met the criteria, with an average age of 51.71 (12.80) years, mean systolic blood pressure of 126.2 (22.25) mmHg, and mean diastolic blood pressure of 74.46 (11.49) mmHg. A significant correlation between age and systolic blood pressure was observed (p-value: 0.001; r: 0.323, indicating a weak association), while no significant correlation was found between age and diastolic blood pressure.Conclusion: The physiological aging process is an unavoidable risk factor for hypertension. It is crucial to Increase awareness about the importance of a healthy lifestyle and optimal hypertension control.

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Management of Hypertension in the Elderly and Frail Patient

Cited by 27 publications

References 109 publications

Influence of Aging on Outcomes of Sacubitril/Valsartan in Hypertensive Patients with Heart Failure: A Multicenter Retrospective Study

Influence of Aging on Outcomes of Sacubitril/Valsartan in Hypertensive Patients with Heart Failure: A Multicenter Retrospective Study

Association between the blood urea nitrogen-to-creatinine ratio and 3-month outcomes in patients with acute ischemic stroke: a secondary analysis based on a prospective cohort study

Gambaran Tekanan Darah serta Korelasinya Terhadap Usia di Rukun Warga 008 Keluruhan Cipondoh Makmur

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