Journal ArticleDOI
Treatment of Hypertension in the Elderly
TLDR
Clinical trials in older hypertensive patients have shown that more benefits accrue when the goal blood pressure is achieved than if a specific antihypertensive agent is chosen as initial therapy, and it is not appropriate to limit the choice of initial drug for hypertensive older individuals to a single class of agents.Abstract:
Hypertension is a common condition among older people in most developed countries, and is a very important, if not the most important, risk factor for all subtypes of vascular disease and death. Many clinical trials in older people have demonstrated significant reductions in myocardial infarctions and strokes when antihypertensive drugs are provided. Lifestyle modifications are still recommended because they can lower a surrogate end point--blood pressure--but there are no data showing they reduce event rates. It is not appropriate to limit the choice of initial drug for hypertensive older individuals to a single class of agents, since so many older people have other medical problems that affect this decision. Monotherapy with an alpha blocker, however, is no longer recommended, even for men with hypertension and benign prostatic hypertrophy, as doxazosin was associated with a higher rate of cardiovascular events in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. The classic strategy of an initial diuretic (for at least 1 month) will likely be verified by the final results of ongoing randomized trials, expected in 2003. Until then, this strategy is effective, inexpensive, and unlikely to cause many adverse effects. Probably the most important exhortation, however, should be to achieve the blood pressure goal appropriate for the patient's risk status. Numerous clinical trials in older hypertensive patients have shown that more benefits accrue when the goal blood pressure is achieved than if a specific antihypertensive agent is chosen as initial therapy. Future cardiovascular risk may be related directly to the blood pressure attained, rather than to how it was attained.read more
Citations
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ACCF/AHA Expert Consensus Document ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents
Wilbert S. Aronow,Jerome L. Fleg,Carl J. Pepine,Nancy T. Artinian,George Bakris,Alan S. Brown,Keith C. Ferdinand,Mary Ann Forciea,William H. Frishman,Cheryl Jaigobin,John B. Kostis,Giuseppi Mancia,Suzanne Oparil,Eduardo Ortiz,Efrain Reisin,Michael W. Rich,Douglas D. Schocken,Michael A. Weber,Deborah J. Wesley,Robert A. Harrington,Eric R. Bates,Deepak L. Bhatt,Charles R. Bridges,Mark J. Eisenberg,Victor A. Ferrari,John D. Fisher,Timothy J. Gardner,Federico Gentile,Michael F. Gilson,Mark A. Hlatky,Alice K. Jacobs,Sanjay Kaul,David J. Moliterno,Debabrata Mukherjee,Robert Rosenson,James H. Stein,Howard H. Weitz +36 more
TL;DR: The reader should view the expert consensus document as the best attempt of the ACCF and document cosponsors to inform and guide clinical practice in areas where rigorous evidence may not yet be available or evidence to date is not widely applied to clinical practice.
Journal ArticleDOI
ACCF/AHA 2011 expert consensus document on hypertension in the elderly: A report of the american college of cardiology foundation task force on clinical expert consensus documents
Wilbert S. Aronow,Jerome J Fleg,Carl J. Pepine,Nancy T. Artinian,George L. Bakris,Alan S. Brown,Keith C. Ferdinand,Mary Ann Forciea,William H. Frishman,Cheryl Jaigobin,John B Kostis,Giuseppi Mancia,Suzanne Oparil,Eduardo Ortiz,Efrain Reisin,Michael W. Rich,Douglas D. Schocken,Michael Weber,Deborah J. Wesley +18 more
TL;DR: The ACCF/AHA Expert Consensus Document as discussed by the authors was developed as an expert consensus document by the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA), in collaboration with the American Academy of Neurology (AAN), AAN, the American Physicians Association (ACP), American Geriatrics Society (AGS), the American Society of Hypertension (ASH), the ASCN), ASCN, ASCP, American Society for Preventive Cardiology (ASPC), the Association of Black Cardiologists (ABC), and the European
Journal ArticleDOI
ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus documents developed in collaboration with the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension
Wilbert S. Aronow,Jerome L. Fleg,Carl J. Pepine,Nancy T. Artinian,George L. Bakris,Alan Brown,Keith C. Ferdinand,Mary Ann Forciea,William H. Frishman,Cheryl Jaigobin,John B. Kostis,Giuseppi Mancia,Suzanne Oparil,Eduardo Ortiz,Efrain Reisin,Michael W. Rich,Douglas D. Schocken,Michael Weber,Deborah J. Wesley +18 more
TL;DR: In this paper, Bhatt et al. discuss the role of race conditions in the development of FAHA and discuss the importance of race safety in the FAHA program and its role in FAHA.
Journal ArticleDOI
ACCF/AHA 2011 expert consensus document on hypertension in the elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration with the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology,
Wilbert S. Aronow,Jerome L. Fleg,Carl J. Pepine,Nancy T. Artinian,George L. Bakris,Alan S. Brown,Keith C. Ferdinand,Mary Ann Forciea,William H. Frishman,Cheryl Jaigobin,John B. Kostis,Giuseppi Mancia,Suzanne Oparil,Eduardo Ortiz,Efrain Reisin,Michael W. Rich,Douglas D. Schocken,Michael Weber,Deborah J. Wesley,Robert A. Harrington,Eric R. Bates,Deepak L. Bhatt,Charles R. Bridges,Mark J. Eisenberg,Victor A. Ferrari,John D. Fisher,Timothy J. Gardner,Federico Gentile,Michael F. Gilson,Mark A. Hlatky,Alice K. Jacobs,Sanjay Kaul,David J. Moliterno,Debabrata Mukherjee,Robert S. Rosenson,James H. Stein,Howard H. Weitz +36 more
Journal ArticleDOI
A Friendly Dog as Potential Moderator of Cardiovascular Response to Speech in Older Hypertensives
TL;DR: Whether friendly dogs may be an effective intervention for moderating cardiovascular stress responses in older adult hypertensives is evaluated to provide a viable means of decreasing BP surges during stressful activities in older hypertensive.
References
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Journal Article
Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38
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TL;DR: Tight blood pressure control in patients with hypertension and type 2 diabetes achieves a clinically important reduction in the risk of deaths related to diabetes, complications related to Diabetes, progression of diabetic retinopathy, and deterioration in visual acuity.
Journal ArticleDOI
Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial
Lennart Hansson,Alberto Zanchetti,S. George Carruthers,Björn Dahlöf,Dag Elmfeldt,Stevo Julius,Joël Ménard,Karl Heinz Rahn,Hans Wedel,Sten Westerling +9 more
TL;DR: Intensive lowering of blood pressure in patients with hypertension was associated with a low rate of cardiovascular events and the potential benefit of a low dose of acetylsalicylic acid in the treatment of hypertension was assessed.
Journal Article
The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure
Journal ArticleDOI
A Clinical Trial of the Effects of Dietary Patterns on Blood Pressure
Lawrence J. Appel,Thomas Burton Moore,Thomas Burton Moore,Eva Obarzanek,William M. Vollmer,Laura P. Svetkey,Frank M. Sacks,George A. Bray,Thomas M. Vogt,Jeffrey A. Cutler,Marlene M. Windhauser,Pao-Hwa Lin,Njeri Karanja,Denise G. Simons-Morton,Marjorie L. McCullough,Janis F. Swain,Priscilla Steele,Marguerite Evans,Edgar R. Miller,David W. Harsha +19 more
TL;DR: In this paper, the effects of dietary patterns on blood pressure were assessed in a clinical trial, Dietary Approaches to Stop Hypertension, where the subjects were fed a control diet that was low in fruits, vegetables, and dairy products, with a fat content typical of the average diet in the United States.
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