Qualitative analysis of hypertension medical treatment

Qualitative analysis of hypertension medical treatment in the elderly population living in a nursing home in France 

INTRODUCTION 

C. JOYAU1, F. DELAMARRE-DAMIER3, G. VEYRAC1, P. JOLLIET1,2 
(1) Department of Clinical Pharmacology, Institut of Biology, Nantes, France,

(2) EA4275 «Biostatistics, Pharmacoepidemiology and Subjective Health Measures», Medicine University, Nantes
(3) Coordinating physician of nursing home, France and Hospital Practioner, Cholet Hospital, France 


Several studies have shown that hypertension treatment of the elderly patient over 80 years of age could reduce cardiovascular events such as stroke mortality, overall mortality and heart failure [1]. It is therefore appropriate to treat hypertension in patients older than 80 years. In this population, the objective is a systolic blood pressure (SBP) less than 150 mmHg , since a decrease of 20 to 30 mmHg compared with initial SBP is already a significant benefit in terms of morbidity in patients with SBP greater than 180 mmHg [2]. In elderly hypertensive patients, a decrease of SBP below 140 mmHg has not clearly shown a benefit [3]. 

According to experts, antihypertensive therapy in the elderly should not include more than 3 antihypertensive drugs. In case of high blood pressure (>20/10 mmHg above the recommended therapeutic target), dual therapy may be prescribed at the beginning, including thiazide diuretic. The first-line treatment in elderly patients with systolic hypertension is a thiazide diuretic at low doses or dihydropyridine calcium channel blocker [2]. The objective of this study is to describe hypertension medical treatment in nursing home. 


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