Management of elderly patients with sustained hypertension.

Beard, Keith; Bulpitt, CJ; Mascie-Taylor, H.; O’Malley, K; Sever, Peter; Webb, Steven A R

doi:10.1136/bmj.304.6824.412

Cited by 115 publications

(43 citation statements)

References 7 publications

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“…Since this time further evidence for the benefits of treating hypertension in the elderly has become available from the systolic hypertension in elderly patients trial (SHEP), Swedish trial in old patients with hypertension (STOP) and the Medical Research Council trial of hypertension in older adults [2][3][4]. In addition guidelines on the management of elderly patients with sustained hypertension have been published [5]. …”

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confidence: 99%

“…Current expert recommen-pressure controlled (<140/90 mm Hg) [7]. For the dations are that elderly individuals with sustained population aged 65-80 years, case recognition and systolic or diastolic blood pressures of greater than initiation of effective treatment for hypertension has 160/90 mm Hg should be treated [5]. Hypertension is become an urgent aim, because this population has a the main risk factor for stroke with systolic blood low level of pre-existing disability, an appreciable pressures of more than 140 mm Hg accounting annual incidence of stroke (about 1%) and clear evifor 40% strokes in epidemiological studies of attribu-dence of treatment benefit.…”

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Management of hypertension in the elderly: attitudes of general practitioners and hospital physicians.

Ford

Asghar

1995

Brit J Clinical Pharma

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1 The attitudes of general practitioners and hospital physicians to the management of hypertension in the elderly, were examined by responses to a postal questionnaire distributed within the Northern Region, concerning the management of a healthy 75 year old male non-smoker with sustained diastolic or isolated systolic hypertension. 2 Two hundred and fourteen (64%) general practitioners and 127 (70%) hospital physicians responded to the questionnaire. General practitioners stated they would most commonly measure to the nearest 2 mm Hg (47%) as compared with nearest 5 mm Hg (61%) by physicians; P < 0.05. When measuring diastolic blood pressure 16% general practitioners and 31% physicians would use phase IV sounds; P < 0.01. 3 Median levels of hypertension, confirmed by repeated readings, at which antihypertensive therapy would be commenced were similar: 180 (150-230)/100(90-120) mm Hg vs 180 (150-200)/100 (90-120) mm Hg; median (range). The stated use of non-pharmacological methods to lower blood pressure before starting drug therapy was similar (74% vs 63%). General practitioners were more likely to prescribe a thiazide diuretic (70% vs 54%) and less likely to prescribe a calcium channel blocker (14% vs 28%) as first line therapy; data for diastolic hypertension, P < 0.001. 4 Considerable variation exists amongst both general practitioners and physicians in their stated assessment and management of a healthy elderly non-smoking male with sustained hypertension. General practitioners and physicians have similar stated thresholds for treating hypertension but differ in their choice of first line therapy. These results suggest that effective interventions in addition to guidelines need to be developed if hypertension in the elderly is to be consistently managed.

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Management of hypertension in the elderly: attitudes of general practitioners and hospital physicians.

Ford

Asghar

1995

Brit J Clinical Pharma

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“…4,[18][19][20][21] Despite the guidelines, GPs disagreed on whether the hypothetical patient should be treated, with almost half not wishing to treat. This negative attitude of some GPs towards treating the elderly hypertensive, previously noted also by others, 22,23 is clearly not due to ignorance of the true absolute benefits of treating hypertension.…”

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confidence: 99%

Hypertension in the elderly: attitudes of British patients and general practitioners

1998

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The perceptions of patients and GPs of the risk of stroke in treated and untreated elderly hypertensives, and their attitudes towards anti-hypertensive therapy were examined. To explore attitudes of patients to the management of hypertension a qualitative approach was used, employing semi-structured interviews, with subsequent thematic analysis of the transcriptions. A questionnaire study of GPs' attitudes to the same subject was also conducted.The elderly (n ‫؍‬ 75) greatly overestimate the risks of hypertension and the benefits of treatment. Most would accept anti-hypertensive therapy despite being informed of the true risks, citing confidence in their doctor

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“…21,22 Bu amaçla, birinci basamakta çalışan hemşireler hipertansif hastaların kilo, beden kitle indeksi ve bel çevresini düzenli olarak değerlendirmelidir. Beden kitle indeksi 25 ve/veya üzerinde, bel çevresi kadınlarda 88 cm, erkeklerde ise 102 cm ve/veya üzerinde olanlar için diğer sağlık ekibi üyeleri ile birlikte uygun diyet ve egzersiz programı oluşturarak bireyleri olumlu davranış değişikliği için motive etmelidir.…”

Section: 20unclassified

Yaşlılarda Hipertansiyon Yönetiminde Hemşirenin Rolü

Ergün¹

2016

HSP

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ÖZET Yaşlılarda hipertansiyon, 65 yaşın üstü bireylerde sistolik kan basıncının 140 mmHg'nın ya da diastolik kan basıncının 90 mmHg'nın üzerinde olması ile tanımlanır. Yaşın ilerlemesiyle birlikte kan basıncı düzeyi de artmaktadır. Yaşlılarda hipertansiyon yönetimi farmakolojik tedavi yanında; kilo yönetimi, diyet, tuz tüketimi, fiziksel aktivite, sigara, alkol tüketimi ve stresle mücadeleyi kapsayan nonfarmakolojik tedavi ile mümkündür. Hipertansiyon yönetimi birinci basamak sağlık hizmetleri içerisinde önemli yer tutmaktadır. Yapılan birçok çalış-mada hipertansiyonun erken dönemde saptanabilmesi ve hastalığın komplikasyonlarının kontrol altına alınma-sında hemşirenin aktif olarak yer alacağı hipertansiyon yönetiminin önemi üzerinde durulmuştur. Birinci basamakta çalışan hemşireler hastanın tedavi programına uygun olarak vaka yönetimi şeklinde yaşlı hipertansif hastaları takip edebilir ve yaşlının durumuna uygun bakım planı hazırlayarak uygulayabilir. Bu makalede yaşlılarda hipertansiyon yönetiminde hemşirenin rolünün birinci basamak sağlık hizmetleri kapsamında incelenmesi amaç-lanmıştır. Anahtar Kelimeler: Yaşlı, hipertansiyon, hipertansiyon yönetimi, yaşam kalitesi.ABSTRACT Hypertension among elderly is defined as having systolic blood pressure over 140 mmHg or diastolic blood pressure over 90 mmHg at the age of 65 and above. Blood pressure levels rise with increasing age. Besides pharmacological treatment hypertension management in the elderly; weight management, diet, salt intake, physical activity, smoking, alcohol consumption and stress management with covering non-pharmacological treatment is possible.Hypertension management has an important place in primary health care. Many studies have emphasized the importance of hypertension management. Nurses play an active role in it by making early diagnoses of hypertension and getting associated complications under control. Primary health care nurses can monitor elderly hypertensive patients using case management in accordance with the patients' treatment program and can prepare and implement patient care plans. This article is the role of the nurse in the management of hypertension among elderly primary health care aims to examine the scope of services. yon oluşturur. Bu olgularda sistolik kan basıncı ≥140 mmHg, diastolik kan basıncı ise ≤90 mmHg'dır. Keywords1-3 Hipertansiyon 65 yaş ve üzeri kişilerin yarısından fazlasında da ciddi bir sağlık sorunudur. Yaşın ilerlemesiyle birlikte kan basıncı düzeyi de artmaktadır. Yapılan geniş çaplı hipertansiyon prevalansı, 60-69 yaş grubunda % 70, 70-79 yaş grubunda % 76, 80 yaş ve üs-tünde ise % 79.7'ye ulaşmaktadır.1 İzole sistoli-

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Management of elderly patients with sustained hypertension.

Cited by 115 publications

References 7 publications

Management of hypertension in the elderly: attitudes of general practitioners and hospital physicians.

Management of hypertension in the elderly: attitudes of general practitioners and hospital physicians.

Hypertension in the elderly: attitudes of British patients and general practitioners

Yaşlılarda Hipertansiyon Yönetiminde Hemşirenin Rolü

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