ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly

Aronow, Wilbert S.; Fleg, Jerome; Pepine, Carl J.; Artinian, Nancy T.; Bakris, George L.; Brown, Alan S.; Ferdinand, Keith C.; Forciea, Mary Ann; Frishman, William H.; Jaigobin, Cheryl; Kostis, John B.; Mancia, Giuseppi; Oparil, Suzanne; Ortíz, Eduardo; Reisin, Efrain; Rich, Michael W.; Schocken, Douglas D.; Weber, Michael A.; Wesley, Deborah J.

doi:10.1161/cir.0b013e31821daaf6

Cited by 375 publications

(186 citation statements)

References 751 publications

(699 reference statements)

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“…A potential explanation for this observation is that these patients may have closer followup and may receive more intensive medical management compared with those without cardiac comorbidity. It is recognized that isolated systolic hypertension occurs with increasing age, 39 therefore, the relatively lower diastolic and mean arterial systolic pressures observed relative to systolic pressure are anticipated.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Effect of CPAP on BP in Resistant and Nonresistant Hypertension in a Large Clinic-Based Cohort

Walia

Griffith

Foldvary‐Schaefer

et al. 2016

Chest

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Section: Discussionmentioning

confidence: 99%

Longitudinal Effect of CPAP on BP in Resistant and Nonresistant Hypertension in a Large Clinic-Based Cohort

Walia

Griffith

Foldvary‐Schaefer

et al. 2016

Chest

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show abstract

“…On the basis of these results, we conclude that hypertensive treatment is recommended for middle-aged individuals and is becoming established as another means to combat the development of dementia. 26,55 For the elderly, in contrast, the evidence is inconsistent. 17,33 Cancer A prospective study of 363 000 Swedish men showed that the risk of renal-cell cancer was >1.6× to 1.7× and 2.1× to 2.3× increased in men with SBP≥150 mm Hg and DBP≥90 mm Hg, compared with those with SBP<120 mm Hg and DBP<70 mm Hg, respectively.…”

Section: Hypertensive Treatment As a Preventive Therapy For Dementiamentioning

confidence: 99%

Higher Blood Pressure as a Risk Factor for Diseases Other Than Stroke and Ischemic Heart Disease

Kokubo

Iwashima

2015

Hypertension

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H ypertension is an established risk factor for stroke, ischemic heart disease, 1,2 and renal dysfunction. 3 The management and prevention of hypertension are important to the prevention of these diseases. Recent evidence has suggested that hypertension also plays a central role in the underlying pathophysiological condition or at prodromal stages before the development of these diseases. Accumulating evidence also indicates that hypertension seems to be linked with common noncardiovascular diseases including dementia, cancer, oral health diseases (OHDs), and osteoporosis. In this brief review, we organize the reported results about the associations between hypertension and these diseases, discussing mainly epidemiological surveys, with the goal of clarifying the relationships between these diseases and hypertension. Hypertension and Cardiorenal Diseases Atrial FibrillationAtrial fibrillation (AF) is one of the most common types of chronic arrhythmia and is a risk factor for ischemic stroke. 4 The Framingham Heart Study revealed that hypertension increases the risk of AF by factors of 1.5 for men and 1.4 for women.5 The Women's Health Study and a cohort study of Norwegian men showed that high-normal blood pressure (BP) was associated with incident AF.6,7 All of these cohort studies were conducted in Westerners, and these associations were also confirmed in a recent Japanese cohort study. 8 In that investigation, compared with normal BP and normal weight, systolic prehypertension with overweight was shown to be associated with an increased risk of incident AF (P for interaction=0.04). Arterial stiffness, left ventricular hypertrophy, and increased left atrial size are important mediators of the relationship between BP and incident AF. 9 Higher systolic BP (SBP) and overweight may mutually exacerbate left ventricular hypertrophy and hypertension, and consequently, they may synergistically increase the risk of AF. Chronic Kidney Disease and High BPChronic kidney disease (CKD) is characterized by a progressive decline in an individual's glomerular filtration rate over several decades, resulting in permanent kidney dysfunction. Hypertension is consistently demonstrated to be an independent risk factor for declining glomerular filtration rate and the progression of CKD, 10-12 partly because of activation of the renin-angiotensin-aldosterone system and sympathetic nervous system activation. A systematic review and meta-analysis of prospective cohort studies showed that prehypertension is associated with incident end-stage renal disease.3 Compared with a normal BP group, the prehypertensive group had a 1.59× increased risk of end-stage renal disease. Even normal BP increased the risk of end-stage renal disease; this association was accentuated by age, sex, and ethnicity and also varied depending on the study. In addition, a systematic meta-analysis showed that individual components of metabolic syndrome other than elevated BP (hazard ratio, 1.61; 95% confidence interval, 1.29-2.01) were also associated with the develo...

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“…Persons with prior myocardial infarction and hypertension should be treated with beta blockers and angiotensin-converting enzyme inhibitors [1][2][3][4]6,7,11,[14][15][16][17][18][19][20][21][22][23][24][25][26] . Atenolol should not be administered [12][13][14] .…”

Section: Coronary Artery Diseasementioning

confidence: 99%

“…Hypertension is also a major risk factor for angina pectoris and for sudden cardiac death [1][2][3][4][5][6][7] . The blood pressure should be reduced to less than 140/90 mm Hg in patients younger than age 80 years and to less than 150/90 mm Hg in patients aged 80 years and older if tolerated [1][2][3][4][5][6][7] . This editorial will discuss the 2015 American Heart Association/American College of Cardiology/American Society of Hypertension guidelines on treatment of hypertension in patients with coronary artery disease [7] .…”

Section: Introductionmentioning

confidence: 99%

2015 Guidelines on Treatment of Hypertension in Patients With Coronary Artery Disease

Aronow

2015

Journal of Cardiology and Therapy

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Patients with coronary artery disease should have intensive treatment of modifiable coronary risk factors. Dietary sodium should be decreased. Hypertension should be treated with beta blockers and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Long-acting nitrates are effective antianginal and antiischemic medications. Calcium channel blockers may be added if angina pectoris persists despite beta blockers and long-acting nitrates. The American Heart Association/American Society of Cardiology 2015 guidelines recommend a target blood pressure below 140/90 mm Hg in patients with coronary artery disease and with an acute coronary syndrome if they are aged 80 years and younger but below 150 mm Hg if they are ≥80 years of age. Octogenarians should be checked for orthostatic changes with standing, and a a systolic blood pressure below 130 mm Hg and a diastolic blood pressure below 65 mm Hg must be avoided. Caution is advised in lowering the diastolic blood pressure below 60 mm Hg in diabetics or in patients older than 60 years of age. In addition to the beta blockers carvedilol, metoprolol CR/XL, and bisoprolol, patients with hypertension and heart failure should be treated with diuretics and angiotensin- Journal of Cardiology and Therapyconverting enzyme inhibitors or angiotensin receptor blockers, and patients with persistent severe symptoms with aldosterone antagonists if not contraindicated.

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ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly

Cited by 375 publications

References 751 publications

Longitudinal Effect of CPAP on BP in Resistant and Nonresistant Hypertension in a Large Clinic-Based Cohort

Longitudinal Effect of CPAP on BP in Resistant and Nonresistant Hypertension in a Large Clinic-Based Cohort

Higher Blood Pressure as a Risk Factor for Diseases Other Than Stroke and Ischemic Heart Disease

2015 Guidelines on Treatment of Hypertension in Patients With Coronary Artery Disease

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