Magnitude of Hypotension Based on Office and Ambulatory Blood Pressure Monitoring: Results From a Cohort of 5066 Treated Hypertensive Patients Aged 80 Years and Older

Garrote, J.A. Divisón; Ruilope, Luís M.; Sierra, Alejandro de la; Cruz, Juan; Vinyoles, Ernest; Gorostidi, Manuel; Escobar-Cervantes, Carlos; Velilla-Zancada, Sonsoles; Segura, Julián; Banegas, José R.

doi:10.1016/j.jamda.2017.01.015

Cited by 34 publications

(22 citation statements)

References 42 publications

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“…In addition, the readings obtained relate to an individual's BP in their usual daily environment, providing an indication of the effects of environmental and emotional factors on BP . ABPM also appears useful for detecting ambulatory episodes of hypotension . The characteristics of ABPM compared with HBPM and office‐based BP measurement are shown in Table .…”

Section: Resultsmentioning

confidence: 99%

Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: The HOPE Asia Network

Kario

Shin

Chen³

et al. 2019

J of Clinical Hypertension

122

167

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Hypertension is an important public health issue because of its association with a number of significant diseases and adverse outcomes. However, there are important ethnic differences in the pathogenesis and cardio-/cerebrovascular consequences of hypertension. Given the large populations and rapidly aging demographic in Asian regions, optimal strategies to diagnose and manage hypertension are of high importance. Ambulatory | 1251 KARIO et Al.

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Section: Resultsmentioning

confidence: 99%

Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: The HOPE Asia Network

Kario

Shin

Chen³

et al. 2019

J of Clinical Hypertension

122

167

View full text Add to dashboard Cite

show abstract

“…18,19 In hypertension, cerebral hypoperfusion is known to result from the increased vascular resistance and disturbed hemodynamic flow patterns, [11][12][13]20,21 whereas the small vessel disease results from endothelial dysfunction of the blood-brain barrier. 22 Recently, Divisón-Garrote et al 23 using the Spanish Society of Hypertension Ambulatory Blood Pressure Monitoring (ABPM) Registry, showed that hypotension is relatively common in patients with treated hypertension, particularly among elderly individuals. One in three elderly patients with treated hypertension attended in routine clinical practice was potentially at risk of having hypotension, and more than half of them had masked hypotension.…”

Section: Association Of Low Blood Pressure With White Matter Hyperintmentioning

confidence: 99%

“…One in three elderly patients with treated hypertension attended in routine clinical practice was potentially at risk of having hypotension, and more than half of them had masked hypotension. 23 Hypotension is also known to increase the risk of WMHs by inducing cerebral hypoperfusion. 24 In the Cardiovascular Determinants of Dementia Study, both increases and decreases in the diastolic blood pressure (BP) were associated with an increased incidence of periventricular WMH in elderly patients without dementia.…”

Section: Association Of Low Blood Pressure With White Matter Hyperintmentioning

confidence: 99%

Association of Low Blood Pressure with White Matter Hyperintensities in Elderly Individuals with Controlled Hypertension

et al. 2020

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Background and Purpose Both hypertension and hypotension increase cerebral white matter hyperintensities. However, the effects of hypotension in individuals with treated hypertension are unknown. We analyzed the association of low blood pressure with the location and amount of white matter hyperintensities between elderly individuals with controlled hypertension and those without hypertension.Methods We enrolled 505 community-dwelling, cognitively normal elderly individuals from the participants of the Korean Longitudinal Study on Cognitive Aging and Dementia. We measured blood pressure three times in a sitting position using a mercury sphygmomanometer and defined low systolic and diastolic blood pressure as ≤110 and ≤60 mm Hg, respectively. We segmented and quantified the periventricular and deep white matter hyperintensities from 3.0 Tesla fluid-attenuated inversion recovery magnetic resonance images.Results Low systolic blood pressure was independently associated with larger volume of periventricular white matter hyperintensity (P=0.049). The interaction between low systolic blood pressure and hypertension was observed on the volume of periventricular white matter hyperintensity (P=0.005). Low systolic blood pressure was associated with the volume of periventricular white matter hyperintensity in individuals with controlled hypertension (F1,248=6.750, P=0.010), but not in those without hypertension (P=0.380). Low diastolic blood pressure was not associated with the volumes of white matter hyperintensities regardless of presence of controlled hypertension.Conclusions Low systolic blood pressure seems to be associated with larger volume of periventricular white matter hyperintensity in the individuals with a historyof hypertension but not in those without hypertension.

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“…Although the benefit of hypertension treatment in older adults has been clearly demonstrated, several cross-sectional studies have raised questions about the risk of hypotension and related cerebrovascular accidents, falls, and kidney failure 27 , 28 ; thus, the safety of BP reduction at an older age has been a controversial topic.…”

Section: What Is the Optimal Target Blood Pressure In Older Adults?mentioning

confidence: 99%

Hypertension management in older adults

Bilen

Wenger²

2020

F1000Res

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Vascular aging leads to arterial hypertension, which is the leading cause of cardiovascular mortality and morbidity in older adults. Blood pressure reduction is effective in reducing the cardiovascular risk and is safe in ambulatory older adults. It is important to note that blood pressure control in this group of patients is challenging because of comorbidities, polypharmacy, and frailty. Choice of pharmacotherapy is not simple and should be individualized.

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Magnitude of Hypotension Based on Office and Ambulatory Blood Pressure Monitoring: Results From a Cohort of 5066 Treated Hypertensive Patients Aged 80 Years and Older

Cited by 34 publications

References 42 publications

Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: The HOPE Asia Network

Expert panel consensus recommendations for ambulatory blood pressure monitoring in Asia: The HOPE Asia Network

Association of Low Blood Pressure with White Matter Hyperintensities in Elderly Individuals with Controlled Hypertension

Hypertension management in older adults

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