Multiprofessional Treatment of High Blood Pressure in Very Elderly Patients.
BACKGROUND
As the world population ages, patients older than 80 years, known as very elderly, are more frequently found. There are no studies in this age group aimed at analyzing the multidisciplinary intervention in the treatment of systemic arterial hypertension (SAH) and some comorbidities.


OBJECTIVE
To assess the effect of a multidisciplinary approach in very elderly hypertensives cared for at a specialized service.


METHODS
Longitudinal retrospective cohort study in a multidisciplinary service specialized in the SAH treatment in the Brazilian West-Central region. Patients aged 80 years and older by June 2015 were included. Data from the first (V1) and last visit (Vf) were assessed. Anthropometric variables, blood pressure (BP), renal function, pharmacological treatment, lifestyle, comorbidities and cardiovascular events were studied, comparing data from V1 and Vf. Controlled BP was defined as systolic blood pressure (SBP) lower than 140 mm Hg and diastolic blood pressure (DBP) lower than 90 mm Hg. Statistical analyses were performed with SPSSR software, version 21.0. Values of p<0,05 were considered significant.


RESULTS
Data of 71 patients were assessed with a mean follow-up time of 15,22 years. Their mean age at V1 was 69.2 years, and, at Vf, 84.53 years, and 26.8% of them were males. There was a significant reduction in mean SBP (157.3 x 142.1 mm Hg; p<0.001) and DBP (95.1 x 77.8 mm Hg; p<0.001), with an increase in BP control rates from V1 to Vf (36.6 x 83.1%; p<0.001). The number of antihypertensive drugs used increased (1.49 x 2.85; p<0.001), with an increase in the use of angiotensin-converting enzyme inhibitors (22.5 x 46.5%; p=0.004), angiotensin II receptor blockers (4.2 x 35.2%; p<0.001) and calcium-channel blockers (18.3 x 67.6%; p<0.001). There was a reduction in total cholesterol (217.9 x 191 mg/dL; p<0.001) and LDL-cholesterol (139.6 x 119.0 mg/dL; p<0.001), but worsening of the glomerular filtration rate (62.5 x 45.4 mL/min; p<0.001).


CONCLUSIONS
The multidisciplinary intervention in very elderly hypertensives increased BP control rate, with optimization of the pharmacological treatment.
Arterial Hypertension League, Federal University of Goiás, Goiânia, GO, Brazil.
Luciana Muniz Sanches Siqueira Veiga
LM
Jardim
Arterial Hypertension League, Federal University of Goiás, Goiânia, GO, Brazil.
Thiago Veiga
TV
Jardim
Arterial Hypertension League, Federal University of Goiás, Goiânia, GO, Brazil.
Weimar Kunz Sebba Barroso de
WK
Souza
Arterial Hypertension League, Federal University of Goiás, Goiânia, GO, Brazil.
Camila Dutra
CD
Pimenta
Arterial Hypertension League, Federal University of Goiás, Goiânia, GO, Brazil.
Ana Luiza Lima
AL
Sousa
Arterial Hypertension League, Federal University of Goiás, Goiânia, GO, Brazil.
Paulo César Brandão Veiga
PC
Jardim
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers