The influence of frailty syndrome on medication adherence among elderly patients with hypertension

Jankowska‐Polańska, Beata; Dudek, Krzysztof; Szymańska–Chabowska, Anna; Uchmanowicz, Izabella

doi:10.2147/cia.s113994

Cited by 43 publications

(40 citation statements)

References 57 publications

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“…72 In a study by Koizumi et al, 73 frailty in hypertensive patients was associated with limited physical activity, lower body weight, difficulties in ingesting solid foods and performing daily activities, and limitations in performing complex activities of daily living, correlated with the prevalence, treatment and control of hypertension. 73 In another study, Talegawkar et al 74 investigated associations between frailty and adherence to the Mediterranean diet, and found that non-frail patients were more compliant with dietary recommendations than frail patients.…”

Section: Adherence To Treatment In the Elderly Populationmentioning

confidence: 98%

“…70,71 There is a discussion in the available literature regarding the impact of frailty syndrome on adherence. 70,72 In a study by Jankowska et al, frailty was found in 63.9 % of hypertensive patients and was associated with worse adherence to anti-hypertensive treatment. Among factors negatively correlated with adherence, the authors identified being alone and some determinants…”

Section: Adherence To Treatment In the Elderly Populationmentioning

confidence: 99%

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Hypertension and Frailty Syndrome in Old Age: Current Perspectives

Uchmanowicz

Chudiak

Jankowska‐Polańska

et al. 2017

Cardiac Failure Review

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Hypertension is considered the most common disorder in the general population. It is both a health and a financial problem worldwide.The Writing Group of the American Society of Hypertension defines hypertension as a cardiovascular syndrome resulting from a number of interconnected factors. 1 Therefore, a comprehensive evaluation is required, involving both the cardiovascular system and other risk factors. In the global population, the prevalence of hypertension is 26.4 %, which is expected to increase to one-third of the population by 2025. 2 The elderly comprise a special group of hypertensive patients because of ageing-related processes. In accordance with data from the Framingham study, 58.9 % of people aged ≥65 and 70 % of those aged ≥80 years are hypertensive. 3 Most patients in the group have isolated systolic hypertension, with normal diastolic blood pressure (DBP) valuesbelow 90 mmHg. In the elderly population, systolic blood pressure (SBP) is a more significant risk factor for cardiovascular complications than DBP. Chronic high SBP leads to left ventricular hypertrophy, as decreased elasticity of large blood vessels -particularly the aortaputs extra strain on the heart. 4 The ageing process involves a number of changes contributing to the development of hypertension. Besides decreased blood vessel elasticity, these include increased collagen content in the extracellular matrix, decreased numbers of elastic fibres, increased vessel wall thickness, and decreased vessel lumen.In the elderly, the lower number of elastic fibres in the vessel wall contributes to increased SBP. AbstractHypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease. Considering the physiological changes resulting from ageing alongside multiple comorbidities, treatment of hypertension in elderly patients poses a significant challenge to treatment teams. Progressive disability with regard to the activities of daily life, more frequent hospitalisations and low quality of life are often seen in elderly patients. There is discussion in the literature regarding frailty syndrome associated with old age. Frailty is understood to involve decreased resistance to stressors, depleted adaptive and physiological reserves of a number of organs, endocrine dysregulation and immune dysfunction. The primary dilemma concerning frailty is whether it should only be defined on the basis of physical factors, or whether psychological and social factors should also be included. Proper nutrition and motor rehabilitation should be prioritised in care for frail pa...

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Section: Adherence To Treatment In the Elderly Populationmentioning

confidence: 98%

Section: Adherence To Treatment In the Elderly Populationmentioning

confidence: 99%

Hypertension and Frailty Syndrome in Old Age: Current Perspectives

Uchmanowicz

Chudiak

Jankowska‐Polańska

et al. 2017

Cardiac Failure Review

Self Cite

View full text Add to dashboard Cite

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“…Higher level of frailty in the elderly has been proposed to be a determinant of lower adherence (74). A decrease in physical activity and difficulty in walking negatively affect adherence (71,75).…”

Section: Frailty and Adherence To Treatmentmentioning

confidence: 99%

“…The ISS report -based on available data on April 13th, 2020 (18,641 deaths)-warned that the mean age of patients dying for SARS-CoV-2 infection was 79 years (median 80, range 5-100, IQR [73][74][75][76][77][78][79][80][81][82][83][84][85][86]. Women dying for SARS-CoV-2 infection had an older age than men (median age women 83-median age men 79).…”

Section: Introductionmentioning

confidence: 99%

Covid-19 Pandemic: Maximizing Future Vaccination Treatments Considering Aging and Frailty

Palermo

2020

Front. Med.

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The COVID-19 pandemic is proving to be a multiplier of inequalities. Especially toward the elderly population. A voiceless scream that comes from geriatrics, nursing homes, hospices from all over Italy. They call it the silent massacre: from North to South, the bulletin of coronavirus positive-or already deceased-elderly people continues to grow exponentially without a chance to counter it. Population aging and chronicity are a question that needs to be addressed. Frailty is the most challenging expression of population aging, with major consequences for public health and clinical practice. It is a geriatric syndrome which consists in a state of higher vulnerability to stressors attributed to a lower homeostatic reserve due to an age-related multisystem physiological change. People over 60, and especially over 80, are particularly vulnerable to severe or fatal infection. Moreover, the age-related dysregulation of the immune system in the elderly (i.e., immunosenescence and inflammaging) results in poorer responses to vaccination. Physical frailty is an effective health indicator and it has previously shown to predict the response to the seasonal flu vaccine. These findings suggest that assessing frailty in the elderly may identify those who are less likely to respond to immunization and be at higher risk for COVID-19 and its complications. Moreover, cognitive frailty and neurocognitive disorders, mental health and reduced awareness of illness negatively impact on adherence to complex medication regimens among elderly patients. A worldwide research and development blueprint have been initiated to accelerate the development of vaccines and therapeutics for the COVID-19 outbreak. Considered the above, I suggest the importance to consider aging in thinking about future Civud-19 vaccination and treatment, focusing on the possible impact of physical and cognitive frailty.

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“…Acredita-se que quanto maior o grau de fragilidade, menor o cumprimento da prescrição. 23,24 Sabe-se também que em idosos com grande comprometimento cognitivo o tratamento, além de não trazer benefícios, pode ainda piorar a cognição. 25 Outro risco de se baixar a PA de idosos frágeis está no fato de alguns deles necessita-rem de níveis pressóricos mais elevados para manter a perfusão de alguns órgãos, dada a rigidez dos vasos por aterosclerose.…”

Section: Tabela 3 Ações Esperadas E Efeitos Adversos De Medicações Aunclassified

Hipertensão arterial no idoso saudável e no idoso frágil: uma revisão narrativa

Costa

Lourenço

2018

Revista HUPE

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Introdução: Sabe-se que, com o envelhecimento populacional, a prevalência de doenças crônicas, como a hipertensão arterial (HA), aumenta. Além disso, a fisiologia do envelhecimento e de comorbidades a ele associadas faz com que seja necessário rever pontos de corte para definição de hipertensão no idoso, principalmente nos mais frágeis. Objetivo: Descrever, por meio de uma revisão narrativa, as recomendações para o tratamento da HA no paciente idoso e, especialmente, no frágil. Métodos: revisão bibliográfica referente à HA no idoso, em bases de dados de pesquisa on-line. Resultados: Foram compiladas diretrizes nacionais, internacionais, além de artigos originais e de revisão sobre o assunto. Observou-se que não há um consenso quanto ao tratamento da HA, que este tratamento deve ser individualizado e que os efeitos colaterais das medicações precisam ser levados em consideração. Conclusão: Concluímos que os efeitos colaterais e interações entre drogas devem ser considerados na escolha da medicação. Entende-se que a hipotensão pode predispor a efeitos indesejados como quedas e sonolência, por estes motivos, tanto o nível de referência quanto o alvo a ser atingido são maiores do que na população mais jovem.Descritores: Hipertensão arterial; Idoso; Fragilidade.

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The influence of frailty syndrome on medication adherence among elderly patients with hypertension

Cited by 43 publications

References 57 publications

Hypertension and Frailty Syndrome in Old Age: Current Perspectives

Hypertension and Frailty Syndrome in Old Age: Current Perspectives

Covid-19 Pandemic: Maximizing Future Vaccination Treatments Considering Aging and Frailty

Hipertensão arterial no idoso saudável e no idoso frágil: uma revisão narrativa

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