PHARMACOTHERAPY OF ARTERIAL HYPERTENSION IN ELDERLY PATIENTS: FOCUS ON OCTOGENARIANS
https://doi.org/10.20996/1819-6446-2016-12-2-210-219
Abstract
Pharmacotherapy of arterial hypertension in the elderly is discussed. Russian and international guidelines are presented with a focus on target levels of blood pressure and drugs of choice in these patients. Issues of efficacy and safety of antihypertensive therapy in patients aged 80 years and older are considered.
About the Authors
E. A. Ushkalova
Russian University of Peoples' Friendship, Moscow
Russian Federation
Russian Federation
O. N. Tkacheva
Russian Gerontological Research and Clinical Center, Moscow
Russian Federation
Russian Federation
N. K. Runikhina
Russian Gerontological Research and Clinical Center, Moscow
Russian Federation
Russian Federation
N. A. Chukhareva
Scientific Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov, Moscow
Russian Federation
Russian Federation
A. Yu. Bevz
Russian Gerontological Research and Clinical Center, Moscow
Russian Federation
Russian Federation
References
1. Bramlage, P., Hasford, J. Blood pressure reduction, persistence and costs in the evaluation of antihypertensive drug treatment—a review. Cardiovasc Diabetol 2009; 8 (18): 2840-8.
2. Mozaffarian, D., Benjamin, E.J., Go, A.S., et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation 2015 131 (4): e29-322.
3. Pimenta E, Oparil S. Management of hypertension in the elderly. Nat Rev Cardiol 2012;9:286-96.
4. Kaiser EA, Lotze U, Schäfer HH. Increasing complexity: which drug class to choose for treatment of hypertension in the elderly? Clin Interv Aging 2014;9:459-75.
5. Aronow WS, Fleg JL, Pepine CJ, et al. ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. Circulation 2011;123(21):2434-506.
6. Lewington S, Clarke R, Qizilbash N, et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-13.
7. Angeli F, Reboldi G, Verdecchia P. Hypertension and the J-curve phenomenon: implications for tight blood pressure control. Hypertens Res 2013; 36: 109-11.
8. Buford TW. Hypertension and aging. Ageing Res Rev 2016; 26:96-111.
9. Turnbull F, Neal B, Ninomiya T, et al. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials. BMJ 2008;336(7653):1121-3.
10. Musini VM, Tejani AM, Bassett K, et al. Pharmacotherapy for hypertension in the elderly. Cochrane Database Syst Rev 2009;4:CD00028.
11. Briasoulis A, Agarwal V, Tousoulis D, Stefanadis C. Effects of antihypertensive treatment in patients over 65 years of age: a meta-analysis of randomised controlled studies. Heart 2014;100(4):317-23.
12. Xue H, Lu Z, Tang WL, et al. First-line drugs inhibiting the renin angiotensin system versus other firstline antihypertensive drug classes for hypertension. Cochrane Database Syst Rev 2015;1:CD008170.
13. Diagnosis and treatment of hypertension. Russian recommendation (4th revision). Arterial'nye gipertenzii 2010; (3): 5-26. In Russian (Диагностика и лечение артериальной гипертонии. Российские рекомендации (4-й пересмотр). Артериальные гипертензии 2010; (3): 5-26).
14. Mancia G, Fagard R, Narkiewicz K, et al. ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013;34(28):2159-219.
15. Houle SK, Padwal R, Tsuyuki RT. The 2012-2013 Canadian Hypertension Education Program (CHEP) guidelines for pharmacists: An update. Can Pharm J (Ott) 2013;146(3):146-50.
16. National Clinical Guideline Centre (UK). Hypertension: The Clinical Management of Primary Hypertension in Adults: Update of Clinical Guidelines 18 and 34. London: Royal College of Physicians (UK); 2011 Aug.
17. Weber MA, Schiffrin EL, White WB. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens (Greenwich) 2014;16(1):14-26.
18. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014;311(5):507-20.
19. Gueyffier F, Bulpitt C, Boissel J-P, et al. Antihypertensive drugs in very old people: a sub-group metaanalysis of randomised controlled trials. Lancet 1999;353:793-6.
20. Beckett NS, Peters R, Fletcher AE, et al., HYVET Study Group. Treatment of hypertension in patients 80 years of age or older.N Engl J Med 2008; 358(18):1887-98.
21. Butt DA, Harvey PJ. Benefits and risks of antihypertensive medications in the elderly. J Intern Med 2015;278(6):599-626.
22. Benetos A, Rossignol P, Cherubini A, et al. Polypharmacy in the Aging Patient: Management of Hypertension in Octogenarians. JAMA 2015;314(2):170-80.
23. Warwick J, Falaschetti E, Rockwood K, et al. No evidence that frailty modifies the positive impact of antihypertensive treatment in very elderly people: an investigation of the impact of frailty upon treatment effect in the HYpertension in the Very Elderly Trial (HYVET) study, a double-blind, placebo-controlled study of antihypertensives in people with hypertension aged 80 and over. BMC Med 2015;13:78.
24. Bejan-Angoulvant T, Saadatian-Elahi M, Wright JM, et al. Treatment of hypertension in patients 80 years and older: the lower the better? A meta-analysis of randomized controlled trials. J Hypertens 2010;28(7):1366-72.
25. Rastas S, Pirttila T, Viramo P, et al. Association between blood pressure and survival over 9 years in a general population aged 85 and older. J Am Geriatr Soc 2006;54:912-8.
26. Oates DJ, Berlowitz DR, Glickman ME, et al. Blood pressure and survival in the oldest old. J Am Geriatr Soc 2007;55:383-8.
27. Benetos A, Buatois S, Salvi P, et al. Blood pressure and pulse wave velocity values in the institutionalized elderly aged 80 and over: baseline of the PARTAGE study. J Hypertens 2010;28(1):41-50.
28. Benetos A, Labat C, Rossignol P, et al. Treatment With Multiple Blood Pressure Medications, Achieved Blood Pressure, and Mortality in Older Nursing Home Residents: The PARTAGE Study. JAMA Intern Med 2015;175(6):989-95.
29. Schall P, Wehling M. Treatment of arterial hypertension in the very elderly: a meta-analysis of clinical trials. Arzneimittelforschung 2011;61(4):221-8.
30. Wiysonge CS, Bradley HA, Volmink J, et al. Beta-blockers for hypertension. Cochrane Database Syst Rev 2012;11:CD002003.
31. Kuyper LM, Khan NA. Atenolol vs nonatenolol β-blockers for the treatment of hypertension: a metaanalysis. Can J Cardiol 2014;30(5 Suppl):S47-53.
32. Levi Marpillat N, Macquin-Mavier Tropeano A, et al. Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J Hypertens 2013;31(6):1073-82.
33. Zhuang S, Li J, Wang X, et al. Renin-angiotensin system-targeting antihypertensive drugs and risk of vascular cognitive impairment: A meta-analysis. Neurosci Lett 2016;615:1-8.
34. Tully PJ, Hanon O, Cosh S, Tzourio C. Diuretic antihypertensive drugs and incident dementia risk: a systematic review, meta-analysis and meta-regression of prospective studies. J Hypertens. 2016 Feb 17. [Epub ahead of print]
35. Parsons C, Murad MH, Andersen S, et al. The effect of antihypertensive treatment on the incidence of stroke and cognitive decline in the elderly: a meta-analysis. Future Cardiol 2016;12(2):237-48.
36. Peters R, Booth A, Peters J. A systematic review of calcium channel blocker use and cognitive decline/dementia in the elderly. J Hypertens 2014;32(10):1945-57.
37. van der Wardt V, Logan P, Conroy S, et al. Antihypertensive treatment in people with dementia. Am Med Dir Assoc 2014;15(9):620-9.
38. Welsh TJ, Gladman JR, Gordon AL. The treatment of hypertension in people with dementia: a systematic review of observational studies. BMC Geriatr 2014;14:19.
39. Xin W, Lin Z, Li X. Orthostatic hypotension and the risk of congestive heart failure: a meta-analysis of prospective cohort studies. PLoS One 2013;8(5):e63169.
40. Veronese N, De Rui M, Bolzetta F, et al. Orthostatic Changes in Blood Pressure and Mortality in the Elderly: The Pro.V.A Study. Am J Hypertens 2015;28(10):1248-56.
41. Canney M, O'Connell MD, Murphy CM, et al. Single Agent Antihypertensive Therapy and Orthostatic Blood Pressure Behaviour in Older Adults Using Beat-to-Beat Measurements: The Irish Longitudinal Study on Ageing. PLoS One 2016;11(1):e0146156.
42. Zia A, Kamaruzzaman SB, Tan MP. Blood pressure lowering therapy in older people: Does it really cause postural hypotension or falls? Postgrad Med 2015;127(2):186-93.
43. Gribbin J, Hubbard R, Gladman J, et al. Risk of falls associated with antihypertensive medication: selfcontrolled case series. Pharmacoepidemiol Drug Saf 2011;20(8):879-84.
44. Butt DA, Mamdani M, Austin PC, et al. The risk of falls on initiation of antihypertensive drugs in the elderly. Osteoporos Int 2013;24(10):2649-57.
45. Lipsitz LA, Habtemariam D, Gagnon M, et al. Reexamining the Effect of Antihypertensive Medications on Falls in Old Age. Hypertension 2015;66(1):183-9.
46. Zang G. Antihypertensive drugs and the risk of fall injuries: a systematic review and meta-analysis. J Int Med Res 2013;41(5):1408-17.
47. Park H, Satoh H, Miki A, et al. Medications associated with falls in older people: systematic review of publications from a recent 5-year period. Eur J Clin Pharmacol 2015;71(12):1429-40.
48. Butt DA, Mamdani M, Austin PC, et al. The risk of hip fracture after initiating antihypertensive drugs in the elderly. Arch Intern Med 2012;172(22):1739-44.
49. Corrao G, Mazzola P, Monzio Compagnoni M, et al. Antihypertensive Medications, Loop Diuretics, and Risk of Hip Fracture in the Elderly: A Population-Based Cohort Study of 81,617 Italian Patients Newly Treated Between 2005 and 2009. Drugs Aging 2015;32(11):927-36.
50. Callisaya ML, Sharman JE, Close J, et al. Greater daily defined dose of antihypertensive medication increases the risk of falls in older people a population-based study. J Am Geriatr Soc 2014; 62: 1527- 33.
51. Ham AC, Swart KM, Enneman AW et al. Medication-related fall incidents in an older, ambulant population: the B-PROOF study. Drugs Aging 2014; 31: 917-27.
52. Tinetti ME, Han L, Lee DSH et al. Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Intern Med 2014; 174: 588-95.
53. Aung K, Htay T. Thiazide diuretics and the risk of hip fracture. Cochrane Database Syst Rev 2011;(10):CD005185.
54. Wiens M, Etminan M, Gill SS, Takkouche B. Effects of antihypertensive drug treatments on fracture outcomes: a meta-analysis of observational studies. J Intern Med 2006;260(4):350-62.
55. Peters R, Beckett N, Burch L et al. The effect of treatment based on a diuretic (indapamide) +/ACE inhibitor (perindopril) on fractures in the Hypertension in the Very Elderly Trial (HYVET). Age Ageing 2010; 39: 609-16.
56. Ruths S, Bakken MS, Ranhoff A, et al. Risk of hip fracture among older people using antihypertensive drugs: a nationwide cohort study. BMC Geriatr 2015;15:153.
57. Khatib R, Yusuf S, Barzilay JI, et al. Impact of lifestyle factors on fracture risk in older patients with cardiovascular disease: a prospective cohort study of 26,335 individuals from 40 countries. Age Ageing 2014;43(5):629-35.
58. El-Bikai R, Tahir MR, Tremblay J, et al. Association of age-dependent height and bone mineral density decline with increased arterial stiffness and rate of fractures in hypertensive individuals. J Hypertens 2015;33(4):727-35.
59. Arrabal-Martín M, González-Torres S, Cano-García MC. Treatment with hydrochlorothiazide and alendronate in patients with stones and bone mineral density loss. Evolution of bone metabolism and calciuria with medical treatment Arch Esp Urol 2016;69(1):9-18.
60. Solomon DH, Ruppert K, Zhao Z, et al. Bone mineral density changes among women initiating blood pressure lowering drugs: a SWAN cohort study. Osteoporos Int 2016;27(3):1181-9.
61. Masunari N, Fujiwara S, Nakata Y, et al. Effect of angiotensin converting enzyme inhibitor and benzodiazepine intake on bone loss in older Japanese. Hiroshima J Med Sci 2008;57(1):17-25.
62. Lynn H, Kwok T, Wong SY, et al. Angiotensin converting enzyme inhibitor use is associated with higher bone mineral density in elderly Chinese. Bone 2006;38(4):584-8.
Review
For citations:
Ushkalova E.A., Tkacheva O.N., Runikhina N.K., Chukhareva N.A., Bevz A.Yu. PHARMACOTHERAPY OF ARTERIAL HYPERTENSION IN ELDERLY PATIENTS: FOCUS ON OCTOGENARIANS. Rational Pharmacotherapy in Cardiology. 2016;12(2):210-219. (In Russ.) https://doi.org/10.20996/1819-6446-2016-12-2-210-219
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