SynthesisDeutsches Arzteblatt international2019
The Pharmacological Treatment of Arterial Hypertension in Frail, Older Patients—a Systematic Review
Synthesis in Deutsches Arzteblatt international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Hypertension Treatment in Frail Older Adults: A Systematic Review and Appraisal of Guidelines.Drugs & aging · 2023Pooled it
- Evidence gap on antihyperglycemic pharmacotherapy in frail older adults : A systematic review.Zeitschrift fur Gerontologie und Geriatrie · 2021Pooled it
- [Drug therapy for arterial hypertension and atrial fibrillation in frail patients : Are there any new insights and recommendations?]Innere Medizin (Heidelberg, Germany) · 2024Review
- [Cardiovascular pharmacotherapy in old age].Herz · 2023Article
- Association of low blood pressure and falls: An analysis of data from the Leiden 85-plus Study.PloS one · 2023Article
- [Cardiovascular prevention in old age-Cardiovascular prevention of ageing?]Zeitschrift fur Gerontologie und Geriatrie · 2022Review
- [Pharmacological treatment of cardiovascular diseases in old age : Geriatic perspective].Zeitschrift fur Gerontologie und Geriatrie · 2022Review
- Brazilian Guidelines of Hypertension - 2020.Arquivos brasileiros de cardiologia · 2021Article
- Frailty and hypertension in older adults: current understanding and future perspectives.Hypertension research : official journal of the Japanese Society of Hypertension · 2020Review
- Gold(iii) promoted formation of dihydroquinazolinones: double X-H activation by gold.RSC advances · 2020Article
- In Reply.Deutsches Arzteblatt international · 2019Article
- Depressing Conclusion.Deutsches Arzteblatt international · 2019Article
- [Concepts in geriatric uro-oncology].Der Urologe. Ausg. A · 2019Review
- [Blood pressure-lowering treatment for prevention of recurrent stroke, severe vascular events and dementia in patients with stroke or transient ischemic attack in the past history].Zeitschrift fur Gerontologie und Geriatrie · 2019Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is debated whether the treatment goals and decision-making algorithms for elderly patients with hypertension should be the same as those for younger patients. The American and European guidelines leave decisions about antihypertensive treatment in frail, institutionalized patients up to the treating physician. We therefore systematically searched the literature for publications on the phamacotherapy of arterial hypertension in frail patients.
methodsThe MEDLINE, Embase, and Central databases were systematically searched for randomized, controlled trials (RCTs) and non-randomized studies, including observational studies, on the pharmacotherapy of arterial hypertension in elderly patients since the introduction of the concept of frailty, published over the period 1992-2017.
resultsOut of 19 282 citations for randomized, controlled trials and 5659 for non-randomized trials and observational studies, four RCTs and three observational studies were included in the further analysis. The included RCTs showed a trend to- wards a benefit from pharmacotherapy of hypertension in frail patients with respect to mortality, cardiovascular disease, functional status, and quality of life. On the other hand, some of the observational studies indicated a lower rate of falls and lower mortality among patients who received no antihypertensive treatment.
conclusionIn view of the conflicting findings of RCTs and non-randomized studies, the lower representation of frail subjects in RCTs, and the high risk of bias in non- randomized studies, the findings of the studies included in this review do not enable the formulation of any strictly evidence-based treatment recommendations. As a rule of thumb, the authors propose that a target systolic blood pressure of <150 mmHg should be aimed at in patients whose gait speed is less than 0.8 m/s, while a target range of 130-139 mmHg can be set for patients over age 80 who are no more than mildly frail.
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