[Application of guidelines concerning systolic hypertension in patients over 80 years of age: experience in a geriatric institute].
Application of the guidelines concerning systolic hypertension in patients over 80 years of age: experience in a geriatric institute In order to compare the blood pressures of elderly hypertensive patients treated in accordance with recent guidelines, the authors measured the casual blood pressure of a population of long stay patients. Recent data from the FRAMINGHAM HEART STUDY shows that, in the general population, only 23% of women over 80 years of age attained the target values, a blood pressure less than 140/90 mmHg, and only 35% of those treated for hypertension. Eighty patients in the long stay unit of Allauch Hospital were studied in this transverse study performed from the 23rd to 25th of August 2005. The blood pressure (SBP, DBP and PP) and heart rate at consultation were measured by the same physician with the same sphygmomanometer (OMRON M4). The prescribed antihypertensive medication was noted; the presence of atrial fibrillation and the echocardiographic data including left atrial (LA) diameter in M-mode were also included. Forty-four of the 80 patients included were hypertensive (84% women, average age 88.7 years; 16% men, average age 86 years) and treated with the same objective of blood pressure (BP < 140/90 mmHg). The patients were treated by monotherapy in 6% of cases, bitherapy in 27% of cases, tritherapy in 6.8% of cases, and quadritherapy in 4.5% of cases. The distribution of antihypertensive agents in the patients over 80 years of age was almost identical to that of the ninety years of age group. The target blood pressure was attained in 67.5% of women and 71.5% of men. The incidence of atrial fibrillation in the hypertensive patients over 80 years of age was 32%, and 85.7% of them had dilated left atrium (>40 mm). The authors conclude that target blood pressures were more often attained (68% vs. 35%) in this Geriatric Institute than in the American general population probably because of environmental and motivational reasons, including those of the medical staff.
Escande
M
M
Service du Dr M. Escande, cardiologie et gériatrie, Centre hospitalier, BP 28, Allauch.
Diadema
B
B
D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D017410:Practice Guidelines as Topic; D013599:Systole; D016896:Treatment Outcome
D000959:Antihypertensive Agents