LEADER 02988nam  2200361z- 450 
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035   $a(CKB)5340000000058072
035   $a(oapen)https://directory.doabooks.org/handle/20.500.12854/71145
035   $a(oapen)doab71145
035   $a(EXLCZ)995340000000058072
100   $a20202107d2018      |y         0
101 0 $aeng
135   $aurmn|---annan
181   $ctxt$2rdacontent
182   $cc$2rdamedia
183   $acr$2rdacarrier
200 00$aPerspectives on treating hypertension in old age$eThe burden of polypharmacy, risks of treatment and GPs' treatment probability
210   $aRotterdam$cOPTIMA$d2018
215   $a1 online resource
311 08$a94-6361-126-6 
330   $aWith increasing age, blood pressure rises as a consequence of arterial stiffness and it has been debated whether or not to it is beneficial to treat hypertension in old age especially in >75-year-olds when they have multimorbidity, polypharmacy or frailty. Large hypertension trials showed that lowering SBP in >60-year-olds is beneficial and lowers the risk for myocardial infarction, stroke and all-cause mortality, even in >80-year-olds. However, these trials lack generalizability and typically excluded multimorbid patients that are frail. At the same time, observational studies rose concerns about lowering SBP too much since there are several cohort studies showing a reverse association of low SBP and increased mortality and accelerated cognitive decline especially in >75-year-olds. However, current hypertension guidelines advise physicians to lower SBP to values of even <130mmHg in all patients from the age of 60 years, which fuelled the discussions about the benefits and harms of lowering SBP too much in >75-year-olds under antihypertensive treatment especially when they are frail defined as having low hand grip strength or complex health problems in multiple domains of daily living. The general aim of this thesis is to increase the scientific knowledge about the effects of treating hypertension in >75-year-olds with frailty. This thesis has three aims: 1) to measure the prevalence of polypharmacy in older patients; 2) to test for an association between low SBP and mortality, cognitive function, daily functioning, and QoL in older patients under antihypertensive treatment; and 3) to understand the role that frailty plays in GP decisions about treating hypertension in old age across countries and see if those differences can be explained by country-specific cardiovascular disease burden and life expectancy.
517   $aPerspectives on treating hypertension in old age 
606   $aCardiovascular medicine$2bicssc
610   $aFraitly
610   $aHypertension
610   $aOld Age
615  7$aCardiovascular medicine
700   $aStreit$b Sven$4auth$0988614
906   $aBOOK
912   $a9910341143503321
996   $aPerspectives on treating hypertension in old age$92992010
997   $aUNINA