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An expert opinion from the European Society of Hypertension-European Union Geriatric Medicine Society working group on the management of hypertension in very old, frail subjects

(2016) HYPERTENSION. 67(5). p.820-825
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Abstract
Two years after the publication of the 2013 guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC),1 the ESH and the European Union Geriatric Medicine Society have created a common working group to examine the management of hypertensive subjects aged >80 years. The general term hypertension in the elderly is not sufficiently accurate because it mixes younger old patients (60–70 years) with the oldest old. Our group believes that the management of hypertension in individuals aged ≥80 years should be specifically addressed. Although arbitrary, this cutoff value identifies a population that is expanding faster than any other age group with a 50% increase of life expectancy during the past 50 years2,3; furthermore, the incidence and prevalence of comorbidities, frailty, and loss of autonomy greatly increases after the age of 80 years4; finally, although there is limited evidence on the management of hypertension in this age group, the latest clinical studies indicate that in these patients, treatment may not be the same as in patients in the lower age strata. The aim of this Working Group was to discuss more in-depth treatment aspects of hypertensive patients aged ≥80 years or older, with special focus on the difficulties and uncertainties posed by very old frail individuals. We focused, in particular, on the following points of the 2013 ESH/ESC guidelines: Benefits of treatment. Blood pressure (BP) thresholds and targets. The choice of treatment.
Keywords
NITRIC-OXIDE SYNTHASE, L-ARGININE TRANSPORT, ANGIOTENSIN-CONVERTING ENZYME, OBESITY-INDUCED HYPERTENSION, SYMPATHETIC-NERVE ACTIVITY, REDUCES OXIDATIVE STRESS, FAT-FED RABBITS, BLOOD-PRESSURE, ENDOTHELIAL DYSFUNCTION, METABOLIC SYNDROME

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Citation

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Chicago
Benetos, Athanase, Christopher J Bulpitt, Mirko Petrovic, Andrea Ungar, Enrico Agabiti Rosei, Antonio Cherubini, Josep Redon, et al. 2016. “An Expert Opinion from the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the Management of Hypertension in Very Old, Frail Subjects.” Hypertension 67 (5): 820–825.
APA
Benetos, A., Bulpitt, C. J., Petrovic, M., Ungar, A., Agabiti Rosei, E., Cherubini, A., Redon, J., et al. (2016). An expert opinion from the European Society of Hypertension-European Union Geriatric Medicine Society working group on the management of hypertension in very old, frail subjects. HYPERTENSION, 67(5), 820–825.
Vancouver
1.
Benetos A, Bulpitt CJ, Petrovic M, Ungar A, Agabiti Rosei E, Cherubini A, et al. An expert opinion from the European Society of Hypertension-European Union Geriatric Medicine Society working group on the management of hypertension in very old, frail subjects. HYPERTENSION. 2016;67(5):820–5.
MLA
Benetos, Athanase, Christopher J Bulpitt, Mirko Petrovic, et al. “An Expert Opinion from the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the Management of Hypertension in Very Old, Frail Subjects.” HYPERTENSION 67.5 (2016): 820–825. Print.
@article{7106596,
  abstract     = {Two years after the publication of the 2013 guidelines for the management of arterial hypertension of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC),1 the ESH and the European Union Geriatric Medicine Society have created a common working group to examine the management of hypertensive subjects aged {\textrangle}80 years. The general term hypertension in the elderly is not sufficiently accurate because it mixes younger old patients (60--70 years) with the oldest old. Our group believes that the management of hypertension in individuals aged \ensuremath{\geq}80 years should be specifically addressed. Although arbitrary, this cutoff value identifies a population that is expanding faster than any other age group with a 50\% increase of life expectancy during the past 50 years2,3; furthermore, the incidence and prevalence of comorbidities, frailty, and loss of autonomy greatly increases after the age of 80 years4; finally, although there is limited evidence on the management of hypertension in this age group, the latest clinical studies indicate that in these patients, treatment may not be the same as in patients in the lower age strata.
The aim of this Working Group was to discuss more in-depth treatment aspects of hypertensive patients aged \ensuremath{\geq}80 years or older, with special focus on the difficulties and uncertainties posed by very old frail individuals. We focused, in particular, on the following points of the 2013 ESH/ESC guidelines:
Benefits of treatment.
Blood pressure (BP) thresholds and targets.
The choice of treatment.},
  author       = {Benetos, Athanase and Bulpitt, Christopher J and Petrovic, Mirko and Ungar, Andrea  and Agabiti Rosei, Enrico and Cherubini, Antonio and Redon, Josep and Grodzicki, Tomasz and Dominiczak, Anna and Strandberg, Timo and  Mancia, Giuseppe},
  issn         = {0194-911X},
  journal      = {HYPERTENSION},
  keyword      = {NITRIC-OXIDE SYNTHASE,L-ARGININE TRANSPORT,ANGIOTENSIN-CONVERTING ENZYME,OBESITY-INDUCED HYPERTENSION,SYMPATHETIC-NERVE ACTIVITY,REDUCES OXIDATIVE STRESS,FAT-FED RABBITS,BLOOD-PRESSURE,ENDOTHELIAL DYSFUNCTION,METABOLIC SYNDROME},
  language     = {eng},
  number       = {5},
  pages        = {820--825},
  title        = {An expert opinion from the European Society of Hypertension-European Union Geriatric Medicine Society working group on the management of hypertension in very old, frail subjects},
  url          = {http://dx.doi.org/10.1161/HYPERTENSIONAHA.115.07020},
  volume       = {67},
  year         = {2016},
}

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