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Download Hypertension: Elderly - Guidelines Advisory Committee
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Hypertension: Elderly Reference # 242 Hypertension: Elderly Key Highlights from the Recommended Guideline • Age is no barrier to the benefits of blood pressure control. Scope: Health professionals involved in the care of seniors What aspects of hypertension management apply specifically to older individuals? • Treat hypertension even among patients over 80 years old. [Level of Evidence: M, RA] • Set treatment targets according to systolic blood pressure, not diastolic or pulse pressure since most older patients have isolated systolic hypertension. [Level of Evidence: M, PR, X] • Use the same treatment algorithms, although initial dosages may be smaller. [Level of Evidence: Not stated] [See GAC Summary Hypertension: Pharmacologic Management] • Recommend weight loss and reduction of daily sodium intake to 80 mmol (2.0 g) as these are very beneficial in the elderly. [Level of Evidence: RA] • Titrate medications slowly for patients with wide variations in blood pressure or orthostatic hypotension. [Level of Evidence: Not stated] • Consider the diagnosis of pseudohypertension (due to stiffened or calcified arteries) if the patient does not respond to treatment. [Level of Evidence: C] Levels of Evidence The levels of evidence used to grade the recommendations in this guideline are as follows: Level M Level RA Level RE Level F Level X Level PR Level C Meta-analysis; use of statistical methods to combine the results from clinical trials Randomized controlled trials; also known as experimental studies Retrospective analyses; also known as case-control studies Prospective study; also known as cohort studies, including historical or prospective follow-up studies Cross-sectional surveys; also known as prevalence studies Previous review or position statements Clinical interventions (nonrandomized) www.gacguidelines.ca -1- ension: Elderly Hypertension: Reference # 242 The above recommendations were derived from the following GAC endorsed guideline: National Heart, Lung, and Blood Institute. (2003, May). The seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure: The complete report. Retrieved November 20, 2007 from: http://www.nhlbi.nih.gov/guidelines/hypertension/ Rating (out of 4): Endorsed Date: September 2005 Planned Review Date: September 2008 Ontario Guidelines Advisory Committee 500 University Ave., Suite 650, Toronto, ON M5G 1V7 Telephone: 1-888-512-8173 Fax: 416-971-2462 Email: [email protected] www.gacguidelines.ca -2-
