Pharmacotherapy for hypertension in adults 60 years or older

Musini, Vijaya M; Tejani, Aaron M; Bassett, Ken; Puil, Lorri; Wright, James M

doi:10.1002/14651858.cd000028.pub3

Cited by 37 publications

(31 citation statements)

References 210 publications

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“…The treatment target threshold of BP has been debated by various studies and guidelines. The goal is to reduce morbidity and mortality from renal and cardiovascular disease (Musini et al, 2019).…”

Section: Treatment Threshold and Special Circumstancesmentioning

confidence: 99%

Hypertension: Diagnosis and management in primary care

Afroze¹,

Mohammed

2021

InnovAiT: Education and inspiration for general practice

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The global prevalence of hypertension is high and continues to rise, making it an increasingly common condition managed in primary care. Untreated hypertension can cause end-organ damage leading to complications that increase morbidity and mortality from cardiac, renal, and cerebrovascular disease. Hypertension can significantly affect an individual patient’s quality of life and can cause a considerable strain on the healthcare system. If hypertension is detected early, these events are avoidable, as there is an opportunity for intervention at a much lesser cost. Several proven, highly effective, and well-tolerated lifestyle and drug treatment strategies can achieve reduction in blood pressure. The aim of this article is to illustrate evidence-based steps that are applicable in the diagnosis and management of hypertension in primary care.

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Section: Treatment Threshold and Special Circumstancesmentioning

confidence: 99%

Hypertension: Diagnosis and management in primary care

Afroze¹,

Mohammed

2021

InnovAiT: Education and inspiration for general practice

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“…The FDA recommended blood pressure control as the primary objective of this trial. This recommendation was based on the fact that blood pressure control is a measurable clinical endpoint that impacts cardiovascular mortality, as demonstrated by several clinical trials that have evaluated treatments for patients with hypertension [71]. Of interest, no previous studies of LSA-I-131-MIBG considered blood pressure control as the primary endpoint.…”

Section: Hsa-i-131-mibg For the Treatment Of Patients With Mppgmentioning

confidence: 99%

Targeted Radionuclide Therapy for Patients with Metastatic Pheochromocytoma and Paraganglioma: From Low-Specific-Activity to High-Specific-Activity Iodine-131 Metaiodobenzylguanidine

Jiménez

Erwin

Chasen

2019

Cancers

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Low-specific-activity iodine-131–radiolabeled metaiodobenzylguanidine (I-131-MIBG) was introduced last century as a potential systemic therapy for patients with malignant pheochromocytomas and paragangliomas. Collective information derived from mainly retrospective studies has suggested that 30–40% of patients with these tumors benefit from this treatment. A low index of radioactivity, lack of therapeutic standardization, and toxicity associated with intermediate to high activities (absorbed radiation doses) has prevented the implementation of I-131-MIBG’s in clinical practice. High-specific-activity, carrier-free I-131-MIBG has been developed over the past two decades as a novel therapy for patients with metastatic pheochromocytomas and paragangliomas that express the norepinephrine transporter. This drug allows for a high level of radioactivity, and as yet is not associated with cardiovascular toxicity. In a pivotal phase two clinical trial, more than 90% of patients achieved partial responses and disease stabilization with the improvement of hypertension. Furthermore, many patients exhibited long-term persistent antineoplastic effects. Currently, the high-specific-activity I-131-MIBG is the only approved therapy in the US for patients with metastatic pheochromocytomas and paragangliomas. This review will discuss the historical development of high-specific-activity I-131-MIBG, its benefits and adverse events, and future directions for clinical practice applicability and trial development.

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“…[9][10][11] In contrast pharmacological treatments or dietary substitution for hypertension or statins are supported by robust trial evidence. [12][13][14] A c c e p t e d M a n u s c r i p t -B J G P -B J G P . 2 0 2 0 .…”

Section: Introduction [2978 Words]mentioning

confidence: 99%

NHS Health Checks: an observational study of equity and outcomes 2009–2017

et al. 2021

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Background: The NHS Health Check cardiovascular prevention programme is now 10 years old. Aim: We describe NHS Heath Check attendance, new diagnoses and treatment in relation to equity indicators. Design and Setting: Using a national general practice database 2009-17, we compared NHS Health Check attendance and new diagnoses and treatments, by age, gender, ethnic group and deprivation. Results: In 2013-17, 590,218 eligible people age 40-74 years attended an NHS Health Check (16.9%) and 2,902,598 (83.1%) did not attend. South Asian ethnic groups were most likely to attend and women more than men. New diagnoses were more likely in attendees than non-attendees; hypertension 25/1000 attendees vs 9/1000 in non-attendees; type 2 diabetes 8/1000 vs 3/1000; chronic kidney disease 7/1000 vs 4/1000. In people aged 65 or older, new atrial fibrillation was diagnosed in 5/1000 attendees and 3/1000 non-attendees and for dementia 2/1000 versus 1/1000 respectively. Type 2 diabetes, hypertension and CKD were more likely in more deprived groups, South Asian and black African/Caribbean ethnic groups. Attendees were more likely to be prescribed statins, 26/1000, than non-attendees 8/1000; and anti-hypertensive medicines, 25/1000 vs 13/1000 non-attendees. However, of the 117,963 people with 10% or greater CVD risk eligible for statins only 9,785 (8.3%) were prescribed them. Conclusions: NHS Health Checks uptake remains low. Attendees were more likely than non-attendees to be diagnosed with type 2 diabetes, hypertension and CKD and receive treatment with statins and antihypertensives. Most attendees received neither treatment nor referral. Of those eligible for statins, fewer than 10% were treated.

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Pharmacotherapy for hypertension in adults 60 years or older

Abstract: Analysis 2.4. Comparison 2 Antihypertensive drug therapy vs control according to subgroup (60 to 79 years old and 80 years or older), Outcome 4 Coronary heart disease mortality and morbidity.

Cited by 37 publications

References 210 publications

Hypertension: Diagnosis and management in primary care

Hypertension: Diagnosis and management in primary care

Targeted Radionuclide Therapy for Patients with Metastatic Pheochromocytoma and Paraganglioma: From Low-Specific-Activity to High-Specific-Activity Iodine-131 Metaiodobenzylguanidine

NHS Health Checks: an observational study of equity and outcomes 2009–2017

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