Screening and treatment of hypertension in older adults: less is more?

Anker, Daniela; Santos-Eggimann, Brigitte; Santschi, Valérie; Del Giovane, Cinzia; Wolfson, Christina; Streit, Sven; Rodondi, Nicolas; Chiolero, Arnaud (2018). Screening and treatment of hypertension in older adults: less is more? Public health reviews, 39, p. 26. BMC (part of Springer Nature), United Kingdom 10.1186/s40985-018-0101-z

[img]
Preview
Text
Anker PublicHealthRev 2018.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (873kB) | Preview

Screening and treatment of hypertension is a cornerstone of cardiovascular disease (CVD) prevention. Hypertension causes a large proportion of cases of stroke, coronary heart disease, heart failure, and associated disability and is highly prevalent especially among older adults. On the one hand, there is robust evidence that screening and treatment of hypertension prevents CVD and decreases mortality in the middle-aged population. On the other hand, among older adults, observational studies have shown either positive, negative, or no correlation between blood pressure (BP) and cardiovascular outcomes. Furthermore, there is a lack of high quality evidence for a favorable harm-benefit balance of antihypertensive treatment among older adults, especially among the oldest-old (i.e., above the age of 80 years), because very few trials have been conducted in this population. The optimal target BP may be higher among older treated hypertensive patients than among middle-aged. In addition, among frail or multimorbid older individuals, a relatively low BP may be associated with worse outcomes, and antihypertensive treatment may cause more harm than benefit. To guide hypertension screening and treatment recommendations among older patients, additional studies are needed to determine the most efficient screening strategies, to evaluate the effect of lowering BP on CVD risk and on mortality, to determine the optimal target BP, and to better understand the relationship between BP, frailty, multimorbidity, and health outcomes.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Anker, Daniela; Del Giovane, Cinzia; Streit, Sven; Rodondi, Nicolas and Chiolero, Arnaud

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0301-0422

Publisher:

BMC (part of Springer Nature), United Kingdom

Language:

English

Submitter:

Tanya Karrer

Date Deposited:

13 Sep 2018 12:28

Last Modified:

04 Oct 2018 09:57

Publisher DOI:

10.1186/s40985-018-0101-z

PubMed ID:

30186660

Uncontrolled Keywords:

Frailty Hypertension Older adults Screening

BORIS DOI:

10.7892/boris.119946

URI:

https://boris.unibe.ch/id/eprint/119946

Actions (login required)

Edit item Edit item
Provide Feedback