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.
1
In other countries, similar aging population demographic trends are occurring.
2
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.To read this article in full you will need to make a payment
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References
- The Chief Public Health Officer’s Report on the State of Public Health in Canada.2014 (Public Health in the Future. Available at:) (Accessed September 9, 2016)
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- Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years.JAMA. 2016; 315: 2673-2682
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- 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
- Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjects.J Am Coll Cardiol. 2012; 60: 1503-1511
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Article Info
Publication History
Published online: November 15, 2016
Accepted:
November 10,
2016
Received:
October 17,
2016
Footnotes
See page 592 for disclosure information.
Identification
Copyright
© 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Cuff Artifact, J Curve, and Application of Hypertension Guidelines in the ElderlyCanadian Journal of CardiologyVol. 33Issue 8
- PreviewIn 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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