Blood pressure targets in the elderly

Currie, Gemma; Delles, Christian

doi:10.1097/hjh.0000000000001576

Cited by 12 publications

(9 citation statements)

References 15 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings raise relevant clinical concerns considering the short-and long-term potential consequences of inadequate in-hospital BP assessment. Inappropriate therapeutical management induced by overestimation of blood pressure could in fact lead to orthostatic symptoms with dizziness, thereby increasing the risk of falls and fractures [32, 33].…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Giorno

Heiniger

Balestra

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

Background. The reliability of blood pressure (BP) measurement in hospitalized patients is a topic of debate and the therapeutic implication of the routinely collected BP profiles is probably overestimated. When measurements are performed in elderly patients, further potential sources of misinterpretation occur. Methods. We conducted a subanalysis of a previous study including 79 over 80-year-old hypertensive patients, hospitalized in an internal medicine ward. Five modalities of BP evaluations (measurement by physicians and nurses, self-measurement by patients, Finometer® beat-to-beat finger monitoring, and 24h monitoring) were analyzed, considering agreement and accuracy. Results. The mean (SD) age of the patients was 86.9±4.9 years (50% women). Patients’ self-measurements of both systolic and diastolic BP (SBP and DBP) did not differ significantly from daytime 24-hour monitoring (D24hBPM) (mean difference -1.52, SE 1.71; p: ns and -0.58, SE 1.19 mmHg; p: ns). Conversely, SBP and DBP registered by nurses did significantly differ (mean difference -7.34, SE 1.42; p=0.007 and -4.7, SE 1.05 mmHg; p=0.003). SBP and DBP measured by patients also showed the better concordance, with lowest biases, and narrowest limits of agreements (LoA) and for SBP higher Kappa statistic values (bias 1.5, LoA -28.9 to 31.9; κ 0.563 and bias 0.6, LoA -20.4 to 21.5 mmHg; κ 0.412). The patients’ sensitivity and specificity in predicting hypertensive systolic D24hBPM were 84.8% and 69.7%, respectively. Conclusions. In elderly hospitalized patients an alternative to 24hBPM, self-measurements by patients offer the better agreement and reliability in detecting hypertensive values.

show abstract

Section: Discussionmentioning

confidence: 99%

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Giorno

Heiniger

Balestra

et al. 2019

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…To measure blood pressure, we used a standard protocol employing a stethoscope and sphygmomanometer. In this study, we controlled blood pressure by maintaining systolic blood pressure below 140 mmHg and diastolic blood pressure below 90 mmHg (Currie and Delles, 2018). Uncontrolled hypertension was defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg based on the mean value measured.…”

Section: Data Collectionmentioning

confidence: 99%

“…As the age increases, the blood pressure increases and hypertension is generally considered a normal condition in the elderly (Lee and Park, 2017). To maintain the blood pressure of elderly people at 140/90 mmHg is very difficult (Currie and Delles, 2018). This is associated with various factors such as age, body weight (obese), lower level of education, an unbalanced dietary pattern, regular drinking and non-comorbidities (Yang et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of hypertension and predictive factors of self-efficacy among elderly people with hypertension in institutional-based rehabilitation in Indonesia

Susanto¹,

Rasni²,

Susumaningrum³

et al. 2019

Kontakt

View full text Add to dashboard Cite

Aim: Identification of hypertension factors among elderly people is expected to form appropriate nursing interventions to improve the self-efficacy of patients by modifying factors affecting the blood pressure of elderly people with hypertension. The aim of this study is to investigate the prevalence of hypertension and predictive factors of self-efficacy among elderly people with hypertension in institutionbased rehabilitation (IBR) in Indonesia. Methods: An IBR cross-sectional study was conducted, involving 64 elderly people selected through random sampling. Research data were collected using a structured questionnaire and standard protocol, employing a stethoscope and sphygmomanometer to measure blood pressure. The data were then analysed using descriptive and comparative statistics, as well as multivariate linear regression analyses. Results: The prevalence of systolic and diastolic hypertension among elderly people who lived in the IBR were 31.30% and 45.30%, respectively. The predictors of self-efficacy of the elderly with regard to systolic hypertension were spiritual activity, length of stay, education, the occupation of the elderly before entering the rehabilitation, and dementia; while daily activities, risk of falling, pain, and depression anxiety and stress become significant predictors of self-efficacy in elderly people with diastolic hypertension. Conclusion: This study provides new evidence that signifies the current burden of hypertension and the critical factors of self-efficacy for uncontrolled hypertension among the elderly in the IBR. The study suggests that health-promotion programs should be developed to modify factors of hypertension among elders of IBR in Indonesia.

show abstract

“…In these and similar cases disease annexation is a call for treatment expansion. In many cases critics rightly regard it as a form of "overtreatment" because of insufficient weight accorded to side effects, at individual and collective level, of, for instance, lowering systolic blood pressure down to 120 even in elderly subjects [17,18] or of treating pharmacologically all degrees of osteoporosis without paying attention to concomitant factors favoring bone fractures, the substantive reason of concern [15]. This type of questionable treatment has however a scientific base and is entirely different from frankly inappropriate overtreatment due to poor application of guidelines, complacency to patients' requests or defensive medicine: with its scientific base engrained in the physiological process of disease expansion (previously described) it may grow as an out of control drift.…”

Section: A Recent Uncontrollable Drift?mentioning

confidence: 99%

Nosology expansion: not always for health’s sake

Saracci¹

2019

Eur J Epidemiol

View full text Add to dashboard Cite

Bjørn Hofmann outlines and discusses in this journal [1] six main ways, not mutually exclusive, through which the domain of human disease is expanded, substantively and semantically. The rationale for nosology building is to provide a basic instrument for disease investigation in medical research and practice; these, in turn, have the substantive objective of disease control and, ultimately, of population health maintenance and improvement. The resulting relation between the latter and nosology expansion is therefore indirect as well as subject to changes in the course of time.

show abstract

Blood pressure targets in the elderly

Cited by 12 publications

References 15 publications

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Blood Pressure Measurements with Different Currently Available Methods in Elderly Hypertensive Hospitalized Patients: A Real World Cross-Sectional Study

Prevalence of hypertension and predictive factors of self-efficacy among elderly people with hypertension in institutional-based rehabilitation in Indonesia

Nosology expansion: not always for health’s sake

Contact Info

Product

Resources

About