Achieved systolic blood pressure in older people: a systematic review and meta-analysis

Moraes, Aline; Baena, Cristina P; Muka, Taulant; Buitrago-López, Adriana; Zazula, Ana Denise; Erbano, Bruna Olandoski; Schio, Nicolle Amboni; Guedes, Murilo; Bramer, Wichor M.; Franco, Oscar H.; Faria-Neto, José Rocha

doi:10.1186/s12877-017-0672-4

Cited by 11 publications

(7 citation statements)

References 35 publications

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“…8 However, evidence has shown a reduction in cardiovascular mortality particularly stroke in adults over 60 years who attained systolic BP levels between 130 and 140 mm compared to those with higher levels. 47,48 Additionally, we found lower HBP control rates in the subsidized than in the contributive insurance. These differences need more exploration because patient adherence and the use of non-pharmacological interventions were not assessed in the current analysis.…”

Section: Limitations and Strengthsmentioning

confidence: 73%

Continuity of Care and the Control of High Blood Pressure at Colombian Primary Care Services

Barrera

Oviedo

Silva

et al. 2021

INQUIRY

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Continuity of care (COC) has been associated with lower mortality and hospitalizations and higher high blood pressure (HBP) control rates. This evidence mainly came from high income countries. We aimed to identify conditions associated with controlled HBP, particularly COC, in primary care services (PCSs) affiliated to two health insurances in Colombia, a low-median income country. A longitudinal observational study was carried out using clinical records of hypertensive adults >18 years with ≥4 clinic visits attending a contributive and a subsidized PCS in Cali (Colombia) between 2013 and 2014. Subsidized PCSs were for unemployment people and those at low socio-economic position and contributive for formal workers. COC was measured using the Bice and Boxerman index. Logistic regression models were performed to quantify the relation between COC and controlled HBP (blood pressure <140/90 mmHg). Between 2013 and 2014, among 8797 hypertensive people identified, 1358 were included: 935 (68.8%) and 423 (31.1%) from the contributive and subsidized PCSs, respectively. 856 (62.3%) were women and had a mean age of 67.7 years (SD 11.7). All people were on antihypertensive treatment. Over the study period, 522 (38.4%) people had controlled HBP, 410 (43.9%) in the contributive and 112 (26.5%) in subsidized PCSs. An increase in 1 unit of the COC index is associated with a 161% higher probability of having HBP controlled (OR, 2.61; 95% CI, 1.25–5.44). The odds of having controlled HBP increased as the number of visits rose; for example, people at the fourth visit had a 34% (OR, 1.34; 95% CI, 1.08–1.66) higher probability of reaching the target. Continuity of care was positively associated with controlled HBP. The strengthening of COC can improve the observed low HBP control rates and reduce health inequalities.

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Section: Limitations and Strengthsmentioning

confidence: 73%

Continuity of Care and the Control of High Blood Pressure at Colombian Primary Care Services

Barrera

Oviedo

Silva

et al. 2021

INQUIRY

View full text Add to dashboard Cite

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“…However, hypertension is a common condition in people >60 years old. According to the National Health and Nutrition Examination Survey in 2020, more than 74% of the older population had hypertension [ 44 ] and required blood pressure reduction and cardio-protector treatment to decrease the risk of CVD and death [ 45 , 46 , 47 , 48 , 49 ]. Regarding hypertension prevalence and CVD risk management in our cohort 80% of Ag subjects and 73.3% of C subjects were under treatment, according to the prevalence of these disorders in the general older population, thus they represented a realistic sample group.…”

Section: Discussionmentioning

confidence: 99%

Novel Insight into the Serum Sphingolipid Fingerprint Characterizing Longevity

Barbacini

Torretta

Arosio

et al. 2022

IJMS

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Sphingolipids (SLs) are structural components of the lipid bilayer regulating cell functions. In biological fluids, their distribution is sex-specific and is at variance in aging and many disorders. The aim of this study is to identify SL species associated with the decelerated aging of centenarians. SLs, extracted from serum of adults (Ad, 35–37 years old), aged (Ag, 75–77 years old) and centenarian (C, 105–107 years old) women were analyzed by LC-MS/MS in combination with mRNA levels in peripheral blood mononuclear cells (PBMCs) of SL biosynthetic enzymes. Results indicated in Ag and C vs. Ad a comparable ceramides (Cers) increase, whereas dihydroceramide (dhCer) decreased in C vs. Ad. Hexosylceramides (HexCer) species, specifically HexCer 16:0, 22:0 and 24:1 acyl chains, increased in C vs. Ag representing a specific trait of C. Sphingosine (Sph), dihydrosphingosine (dhSph), sphingosine-1-phosphate (S1P) and dihydrosphingosine-1-phosphate (dhS1P), increased both in Ag and C vs. Ad, with higher levels in Ag, indicating a SL fine-tuning associated with a reduced physiological decline in C. mRNA levels of enzymes involved in ceramide de novo biosynthesis increased in Ag whereas enzymes involved in sphingomyelin (SM) degradation increased in C. Collectively, results suggest that Ag produce Cers by de novo synthesis whereas C activate a protective mechanism degrading SMs to Cers converting it into glycosphingolipids.

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“…In middle-aged adults, the risk for cardiovascular events, cardiovascular mortality, and all-cause mortality increases with increasing BP [5]. Likewise, numerous trials in middle-aged adults [32–35], and others like SHEP [36] and Syst-Eur [37], which enrolled participants 60 years and over, have shown that lowering BP with antihypertensive treatment reduces mortality and CVD risk.…”

Section: Blood Pressure and Related Outcomes: Evidence From Trials Anmentioning

confidence: 99%

Screening and treatment of hypertension in older adults: less is more?

et al. 2018

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Screening and treatment of hypertension is a cornerstone of cardiovascular disease (CVD) prevention. Hypertension causes a large proportion of cases of stroke, coronary heart disease, heart failure, and associated disability and is highly prevalent especially among older adults. On the one hand, there is robust evidence that screening and treatment of hypertension prevents CVD and decreases mortality in the middle-aged population. On the other hand, among older adults, observational studies have shown either positive, negative, or no correlation between blood pressure (BP) and cardiovascular outcomes. Furthermore, there is a lack of high quality evidence for a favorable harm-benefit balance of antihypertensive treatment among older adults, especially among the oldest-old (i.e., above the age of 80 years), because very few trials have been conducted in this population. The optimal target BP may be higher among older treated hypertensive patients than among middle-aged. In addition, among frail or multimorbid older individuals, a relatively low BP may be associated with worse outcomes, and antihypertensive treatment may cause more harm than benefit. To guide hypertension screening and treatment recommendations among older patients, additional studies are needed to determine the most efficient screening strategies, to evaluate the effect of lowering BP on CVD risk and on mortality, to determine the optimal target BP, and to better understand the relationship between BP, frailty, multimorbidity, and health outcomes.

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Achieved systolic blood pressure in older people: a systematic review and meta-analysis

Cited by 11 publications

References 35 publications

Continuity of Care and the Control of High Blood Pressure at Colombian Primary Care Services

Continuity of Care and the Control of High Blood Pressure at Colombian Primary Care Services

Novel Insight into the Serum Sphingolipid Fingerprint Characterizing Longevity

Screening and treatment of hypertension in older adults: less is more?

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