Considerations for Optimal Blood Pressure Goals in the Elderly Population: A Review of Emergent Evidence

2018 ◽  
Vol 38 (3) ◽  
pp. 370-381 ◽  
Author(s):  
Diana X. Cao ◽  
Rebecca J. C. Tran
Keyword(s):  
Blood Pressure ◽  
Elderly Population ◽  
The Elderly ◽  
Blood Pressure Goals ◽  
Optimal Blood Pressure

Abstract WMP57: Declining Blood Pressure is Associated with Subcortical Microinfarcts in Older Adults

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mekala R Raman ◽  
Jonathan Graff-Radford ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Elderly Population ◽  
Adult Population ◽  
Blood Pressure Measurement ◽  
The Elderly ◽  
Pressure Measurements ◽  
Autopsy Study ◽  
Cross Sectional ◽  
Blood Pressures

Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.

scholarly journals METABOLIC SYNDROME PREVALENCE IS NOT ASSOCIATED WITH DIET QUALITY IN THE CHILEAN ELDERLY POPULATION: A CROSS SECTIONAL ANALYSIS FROM THE NATIONAL HEALTH SURVEY 2009-2010

2016 ◽  
pp. 1-7
Author(s):  
C. Dussaillant ◽  
G. Echeverría ◽  
L. Villarroel ◽  
C.B. Yu ◽  
A. Rigotti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Food Intake ◽  
Diet Quality ◽  
Elderly Population ◽  
The Elderly ◽  
National Health Survey ◽  
Cross Sectional ◽  
Sectional Analysis

Objectives: To analyze the relationship between the prevalence of metabolic syndrome, food intake, and diet quality in elderly (≥65 years old) Chilean population. Design: Cross sectional analysis based on the last national health survey performed in the years 2009 and 2010 (ChNHS 2009-2010). Setting: Non-institutionalized individuals of 65 years or older were selected and visited at home. Participants: A subsample of 505 elderly adults from the ChNHS 2009-2010 who answered a food questionnaire and had appropriate information to diagnose metabolic syndrome following the ATPIII-NCEP guidelines. Measurements: Fasting blood samples were obtained in order to measure blood lipids and fasting blood glucose. Blood pressure, waist circumference, and body mass index (BMI) were also measured. A 5-item food frequency questionnaire was applied to all the participants of NHS 2009-2010. Results: The overall prevalence of metabolic syndrome in the Chilean adult population was 37.7%, increasing in frequency with advancing age. Among the elderly (≥65 years old), metabolic syndrome was found in 57.2% of the sample. Elevated blood pressure and increased waist circumference were the most prevalent metabolic syndrome components among this group (88% and 80%, respectively). Low intake of fruits, vegetables, whole cereals, fish, and dairy was seen among the elderly, and no association was found between food intake nor diet quality and metabolic syndrome prevalence. Conclusion: Metabolic syndrome is highly prevalent among the Chilean elderly population and its prevalence is not associated with food intake or diet quality in this age group.

scholarly journals Aggressive blood pressure reduction in patients at high vascular risk: is it dangerous?

2012 ◽  
Author(s):  
Fabio Angeli ◽  
Gianpaolo Reboldi ◽  
Cristina Poltronieri ◽  
Giovanni Mazzotta ◽  
Marta Garofoli ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Reduction ◽  
Pressure Reduction ◽  
Vascular Risk ◽  
Current State ◽  
J Curve ◽  
Blood Pressure Goals ◽  
Optimal Blood Pressure ◽  
Meta Analyses ◽  
Post Hoc

Introduction The aim of this review was to summarize the current state of evidence regarding the optimal blood pressure goals in patients with high vascular risk. In particular, this review critically addresses the issue of the “J-curve” paradox – a hypothesis indicating that low treatment-induced blood pressure values are characterized by an increase, rather than a decrease, in the incidence of cardiovascular events. Materials and methods We reviewed evidence from studies published in peer-reviewed journals indexed in Medline, EMBASE and CINAHL that compared different BP goals. Results Post-hoc analyses of randomized trials specifically conducted to test the hypothesis of the “J-shaped curve” yielded conflicting results. However, trials directly comparing different blood pressure goals and meta-analyses showed that in-treatment blood pressure values below the usual goal of less than 140/90 mmHg improve outcomes in patients at increased vascular risk. Discussion The fear that an excessive reduction in blood pressure may be dangerous is inconsistent with the available data and probably conditioned by the adverse impact of other risk factors that may be more frequent in patients with low values of achieved blood pressure. The association between blood pressure reduction and cardiovascular risk seems to be linear and not J-shaped.

Prevalence and Risk Factors of Undetected Elevated Blood Pressure in an Elderly Southeast Asian Population

2007 ◽  
Vol 19 (2) ◽  
pp. 3-9 ◽  
Author(s):  
V. Joshi ◽  
J. Lim ◽  
M. Nandkumar
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Elderly Population ◽  
Asian Population ◽  
The Elderly ◽  
Southeast Asian ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
High Prevalence ◽  
The Mean

Data on the prevalence of Hypertension (HTN) among elderly Asians is limited. We investigated the prevalence of elevated blood pressure (EBP) and its risk factors in a multiracial Southeast Asian elderly population who participated in the National Kidney Foundation Singapore nationwide screening programme. Among 19,848 subjects ≥ 65 years (approximately 6% of the total Singapore population), the mean age was 70.6 ± 5.26 yrs. After excluding 36.6% with known HTN, analysis revealed that 5,889 (46.8%) of the remaining population had previously undetected EBP >140/ 90. Increasing age, male gender, BMI ≥ 23 kg/m2 and pre-existing diabetes were significantly associated with previously undetected EBP on multivariate analysis. 6% of cases with undetected EBP had proteinuria suggestive of longstanding EBP and renal damage. We conclude that there is a high prevalence of undetected EBP in elderly Asians, suggesting the need for increased e forts in screening in the elderly population. Asia Pac J Public Health 2007; 19(2): 3—9.

OS 18-08 OPTIMAL BLOOD PRESSURE GOAL FOR THE ELDERLY CHINESE

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e226
Author(s):  
Jiadela Teliewubai ◽  
Yu-Yan Lv ◽  
Shi-Kai Yu ◽  
Bin Bai ◽  
Chen Chi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
The Elderly ◽  
Blood Pressure Goal ◽  
Elderly Chinese ◽  
Optimal Blood Pressure

scholarly journals Blood Pressure and Global Risk Assessment in a Swedish Population

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Jenny Eckner ◽  
Charlotte A. Larsson ◽  
Lennart Råstam ◽  
Ulf Lindblad
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Participation Rate ◽  
Global Risk ◽  
Swedish Population ◽  
Additional Risk ◽  
Global Risk Assessment ◽  
Esc Guidelines ◽  
Blood Pressure Goals ◽  
Optimal Blood Pressure

This study investigated the association between SCORE and the 2007 ESH-ESC blood pressure categories and explored achievements of blood pressure goals considering global risk. In 2001–2005, a random sample of inhabitants aged 30–74 years in southwestern Sweden was invited to a survey of cardiovascular risk factors. The study enrolled 2816 participants (participation rate 76%). Blood pressure was categorized according to the 2007 ESH-ESC guidelines. Global risk of 10-year CVD death was estimated using the Swedish SCORE chart also accounting for additional risk from diabetes (SCORE-DM). SCORE-DM increased in both sexes from optimal blood pressure to manifest hypertension but did not differ between the normal blood pressure categories. However, SCORE-DM became significantly higher among those with temporarily high blood pressure (men 3.3 SD (1.7), women 1.1 (1.8)) and hypertension (3.6 (2.0), 2.0 (2.0)), compared to optimal blood pressure (1.6 (2.9), 0.6 (1.9)). In the presence of both hypertension and diabetes, high-risk subjects dominated (men 76%, women 61%), and correspondingly a major proportion of patients with known hypertension were at high risk at a blood pressure  mm Hg. These findings have strong implications on blood pressure evaluation in clinical practice and support the use of SCORE to evaluate global risk.

scholarly journals Perfil de saúde e qualidade de vida de idosos de Santa Juliana-MG

2014 ◽  
Vol 5 (3/4) ◽  
pp. 61-64
Author(s):  
Álvaro Da Silva Santos ◽  
Joilson Meneguci ◽  
Rodrigo Eurípedes Da Silveira ◽  
Fernanda Avelar Marquez ◽  
Verônica Aparecida Ferreira ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Health Education ◽  
Quantitative Study ◽  
Elderly Population ◽  
The Elderly ◽  
The Self ◽  
Health Profile ◽  
Calidad De Vida

Resumo: Estudo quantitativo que analisou o perfil de saúde e qualidade de vida da população idosa do município de Santa Juliana-MG. Entre os207 idosos, 53,6% eram mulheres, com idade média de 70±7,5 anos. 56% vivem com companheiro e 78,7% são aposentados. A Hipertensão Arterial,a cardiopatia e doenças reumáticas foram as mais relatadas e com relação à qualidade de vida, o domínio meio ambiente era o mais prejudicado. Apesquisa aponta a necessidade de ações de promoção e educação em saúde tendo como foco o autocuidado, a prevenção de agravos e incorporandoestratégias de atenção social ao idoso.Descritores: Perfil de saúde, Idoso, Qualidade de vida.Health profile and quality of life of the elderly in Santa Juliana (MG)Abstract: Quantitative study that examined the health profile and quality of life of the elderly population of the municipality of Santa Juliana-MG.Among the 207 individuals, 53.6% were women, aged about 70 ± 7.5 years. 56% live with companion and 78.7% are retired. High blood pressure, heartdisease and rheumatic diseases were the most reported and with regard to the quality of life, the environment was the most affected. This research pointsthe need for promotional and health education focusing the self-care, prevention of diseases and social attention strategies incorporating the elderly.Descriptors: Health profile; Aged; Quality of life.Perfil de salud y calidad de vida de los ancianos de Santa Juliana (MG)Resumen: Estudio cuantitativo que examina el perfil de salud y la calidad de vida de la población anciana del municipio de Santa Juliana-MG. Entre los207 individuos, 53,6% eran mujeres, con edad media de 70 ± 7,5 años. 56% vive con acompañante y 78.7% son aposentados. La presión arterial alta,enfermedades del corazón y enfermedades reumáticas fueron las más reportadas y con respecto a la calidad de vida, el medio ambiente fue el dominiomás afectado. Esa investigación apunta la necesidad de promoción y educación para la salud centrándose en autocuidado, prevención de enfermedadesy estrategias de atención social incorporando los ancianos.Descriptores: Perfil de salud; Anciano; Calidad de vida.

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