Antihypertensive treatment in people of very old age with frailty : time for a paradigm shift?
Shantsila, Eduard Lip, Gregory Y H Shantsila, Alena Kurpas, Donata Beevers, Gareth Gill, Paramjit S Williams, Nefyn H
Shantsila, Eduard
Lip, Gregory Y H
Shantsila, Alena
Kurpas, Donata
Beevers, Gareth
Gill, Paramjit S
Williams, Nefyn H
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Affiliation
University of Liverpool; Aalborg University; Wrocław Medical University; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2023-07-05
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Abstract
The optimal management of hypertension in individuals aged 80 years or older with frailty remains uncertain due to multiple gaps in evidence. Complex health issues, polypharmacy, and limited physiological reserve make responding to antihypertensive treatments unpredictable. Patients in this age group may have limited life expectancy, so their quality of life should be prioritized when making treatment decisions. Further research is needed to identify which patients would benefit from more relaxed blood pressure targets and which antihypertensive medications are preferable or should be avoided. A paradigm shift is required in attitudes towards treatment, placing equal emphasis on deprescribing and prescribing when optimizing care. This review discusses the current evidence on managing hypertension in individuals aged 80 years or older with frailty, but further research is essential to address the gaps in knowledge and improve the care of this population.
Citation
Shantsila E, Lip GYH, Shantsila A, Kurpas D, Beevers G, Gill PS, Williams NH. Antihypertensive treatment in people of very old age with frailty: time for a paradigm shift? J Hypertens. 2023 Oct 1;41(10):1502-1510. doi: 10.1097/HJH.0000000000003495
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Article