Impact of Guidelines on Hypertension Control in the Elderly.
Impact of Guidelines on Hypertension Control in the Elderly.
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DOI：
10.2174/1381612826666201207230956
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发表时间：
2021
影响因子：
3.1
通讯作者：
Ferri, Claudio
中科院分区：
文献类型：
--
作者：
Del Pinto, Rita;Dobre, Mirela;Pagliacci, Silvia;Ferri, Claudio
关键词：
控制高血压是降低心血管（CV）风险的关键措施，最近已修订血压（BP）治疗目标以解决这一问题。然而，实现建议的目标可能具有挑战性。我们的目的是根据美国高血压指南，在意大利全国流行病学调查的老年参与者中评估未控制高血压的患病率，相关的临床相关性，以及与欧洲指南应用的一致性。参加意大利全国性调查的老年（≥ 65岁）志愿者使用标准方案进行血压测量。未控制的高血压定义为BP≥130/80 mmHg。使用Cohen kappa检验该定义与欧洲指南（≥140/90 mmHg; ≥140/80 mmHg）的一致性。还收集了关于可改变/不可改变CV风险因素的自我报告信息。在13，162名接受治疗的高血压老年人中，69.8%的高血压未得到控制。他们往往是超重/肥胖的糖尿病男性。美国和欧洲指南之间的总体一致性从差到好（分别基于140/90和140/80 mmHg阈值，κ = 0.289，p <0.001和κ = 0.691，p<0.001）。高血压得到控制的老年参与者更有可能报告CV或慢性肾脏疾病史。血压控制状态与生活习惯无差异。真实世界的数据表明，在老年高血压意大利人中，指南在BP目标实现方面的一致性有限，并强调需要传播对CV风险的认识，特别是在存在糖尿病和肥胖的情况下。
Hypertension control is a crucial measure to reduce cardiovascular (CV) risk, and blood pressure (BP) treatment targets have been recently revised to address this issue. However, achieving the recommended goal may be challenging. We aimed to assess the prevalence of uncontrolled hypertension, according to the US hypertension guidelines, among elderly participants in an Italian nationwide epidemiological survey, the relevant clinical correlates, and the agreement with the application of the European guidelines. Elderly (≥65y) volunteers enrolled in an Italian nationwide survey underwent BP measurement using standard protocols. Uncontrolled hypertension was defined as BP≥130/80 mmHg. Agreement of this definition with those from European guidelines (≥140/90 mmHg; ≥140/80 mmHg) was tested using Cohen’s kappa. Self-reported information on modifiable/non-modifiable CV risk factors was also collected. Of the 13,162 treated hypertensive elderly, 69.8% had uncontrolled hypertension. They tended to be overweight/obese men with diabetes. Overall agreement between US and European guidelines was poor to good (κ = 0.289, p<0.001 and κ = 0.691, p<0.001 based on the 140/90 and 140/80 mmHg threshold, respectively). Elderly participants with controlled hypertension were more likely to report a history of CV or chronic kidney disease. No difference in lifestyle habits was observed by BP control status. Real-world data identify limited concordance between guidelines in terms of BP target achievement among older hypertensive Italians and highlights the need to spread awareness of the CV risk, especially in the presence of diabetes and obesity.
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影响因子：
3.5
作者：
Borghi, Claudio;Tubach, Florence;Halcox, Julian P.
通讯作者：
Halcox, Julian P.
影响因子：
24
作者：
Grundy, Scott M.;Stone, Neil J.;Wijeysundera, Duminda N.
通讯作者：
Wijeysundera, Duminda N.
影响因子：
5.2
作者：
Del Pinto, R.;Pietropaoli, D.;Ferri, C.
通讯作者：
Ferri, C.
DOI：
10.1016/j.rec.2017.01.002
发表时间：
2017-02-01
期刊：
Revista espanola de cardiologia (English ed.)
影响因子：
--
作者：
Catapano, Alberico L;Graham, Ian;Cooney, Marie-Therese
通讯作者：
Cooney, Marie-Therese
影响因子：
3.7
作者：
Greyling A;Ras RT;Zock PL;Lorenz M;Hopman MT;Thijssen DH;Draijer R
通讯作者：
Draijer R