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Canadian Journal of Cardiology

Application of Hypertension Guidelines in the Elderly: Revisiting Where the Bridge to Nowhere Might Actually Be Going

Published:November 15, 2016DOI:https://doi.org/10.1016/j.cjca.2016.11.010
      Individuals aged 65 years or older now comprise 15.3% of the Canadian population and, if projections prove accurate, will constitute one-quarter of the populace or 13 million individuals by 2056.
      Public Health Agency of Canada
      The Chief Public Health Officer’s Report on the State of Public Health in Canada.
      In other countries, similar aging population demographic trends are occurring. For clinicians who manage patients with high blood pressure (BP), advanced age substantially complicates the management of hypertension. This is primarily because existing evidence gaps lead to genuine uncertainty as to the threshold for initiating antihypertensive drug therapy and the target BP that should be achieved in older patients.
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      Linked Article

      • Cuff Artifact, J Curve, and Application of Hypertension Guidelines in the Elderly
        Canadian Journal of CardiologyVol. 33Issue 8
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          In a recent editorial,1 Feldman and Padwal cautioned against blanket application of new hypertension guidelines based on the Systolic Blood Pressure Intervention Trial (SPRINT), urging individualized therapy in the frail elderly. This caution is well founded. They mentioned that in the elderly, β-blockers are not recommended as first-line therapy. To better understand the concern, it is worth considering issues not mentioned.
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