机构:[1]Hypertension Center, FuWai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College &Chinese Academy of Medical Sciences, Beijing, Hebei, China.[2]Department of Cardiology, The First Hospital of Kunming, Kunming, Yunnan, China.[3]Department of Cardiology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China.
With population aging, late-life hypertension is becoming an increasingly important issue. Mounting evidence has documented additional cardiovascular benefits induced by a more intensive target, lower than what are recommended in most current guidelines for systolic blood pressure (SBP) reduction in older patients with hypertension. However, the optimal target remains less clear.In the present review, we summarized the evolution of the perspective into late-life hypertension and the development of the 'optimal' target for SBP reduction in older patients with hypertension. More importantly, new evidence from latest antihypertensive drug-placebo studies, blood pressure target studies, and high-quality meta-analysis regarding the effect of intensive SBP treatment in older patients were covered and discussed in detail.In summary, robust evidence supports that a SBP target of <130 mmHg is safe and will induce additional cardiovascular benefits in general older patients with hypertension. This benefit seems to be consistent, but less degreed in older patients with comorbidities such as chronic kidney disease or diabetes mellitus. However, such an intensive SBP target should be judiciously applied in older patients under extreme conditions. Collectively, edging down the relaxed SBP targets to <130 mmHg in most of the current guidelines is in imperative need.
基金:
This article was supported by grants to J Cai from the Beijing Outstanding
Young Scientist Program (BJJWZYJH01201910023029), the Chinese
Academy of Medical Sciences Innovation Fund for Medical Sciences (2021-
I2M-1-007), and the National Natural Science Foundation of China
(No. 81630014 and 81825002).
语种:
外文
PubmedID:
第一作者:
第一作者机构:[1]Hypertension Center, FuWai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College &Chinese Academy of Medical Sciences, Beijing, Hebei, China.
通讯作者:
通讯机构:[1]Hypertension Center, FuWai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College &Chinese Academy of Medical Sciences, Beijing, Hebei, China.[*1]Hypertension Center, FuWai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beilishi Road 167, Xicheng District, Beijing, Hebei 100037, China
推荐引用方式(GB/T 7714):
Deng Yue,Liu Yunlan,Yang Li,et al.Improving outcomes for older hypertensive patients: is more intensive treatment better?[J].Expert review of cardiovascular therapy.2022,20(3):193-205.doi:10.1080/14779072.2022.2058491.
APA:
Deng Yue,Liu Yunlan,Yang Li,Bai Jingjing&Cai Jun.(2022).Improving outcomes for older hypertensive patients: is more intensive treatment better?.Expert review of cardiovascular therapy,20,(3)
MLA:
Deng Yue,et al."Improving outcomes for older hypertensive patients: is more intensive treatment better?".Expert review of cardiovascular therapy 20..3(2022):193-205