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Older adults

Hypertension

12-02-2020 | Older adults | News

Increasing comorbidity linked to poorer care quality for older people with diabetes

The quality of care among older adults with diabetes declines with increasing comorbidity and is particularly low for those with both osteoarthritis and major depression, population-based study data show.

05-12-2018 | Empagliflozin | News

Empagliflozin beneficial for uncontrolled nocturnal hypertension

The addition of empagliflozin reduces nighttime blood pressure in older diabetes patients who have nocturnal hypertension despite medication including angiotensin receptor blockers, show findings from a randomized trial.

04-07-2018 | Mental health | Article

Factors associated with type 2 diabetes in patients with vascular dementia: A population-based cross-sectional study

Liu CL et al. BMC Endocr Disord 2018; 18: 45. doi: 10.1186/s12902-018-0273-z

21-06-2018 | Sleep disorders | Article

Relationship between sleep disturbance and self-care in adults with type 2 diabetes

Zhu B et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1181-4

06-06-2018 | Mental health | Article

The relationship between sleep and cognitive function in patients with prediabetes and type 2 diabetes

Saetung S et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1166-3

Editorial Board member Jay Shubrook follows up with treatment individualization specialist David Strain on the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:08).



Learning points include:

  • The rationale for emphasizing quality over quantity of life in certain subsets of the elderly patient population.
  • The importance of incorporating understanding of key comorbidities into treatment planning, including:
    • Left ventricular and/or diastolic dysfunction
    • Chronic kidney disease 
    • Benign prostatic hyperplasia
    • Heart failure
  • Single/multi-agent therapies capable of targeting hypertension and its comorbidities.
  • The importance of early renal function testing in older adults initiated on treatments for hypertension and its comorbidities.
  • Understanding renal impairment risks in vulnerable adults treated with angiotensin-converting-enzyme (ACE) inhibitors in patients.
  • Understanding the relative risk of hyponatremia with generally well-tolerated treatments like as thiazide diuretics.
  • Best practice for avoiding adverse drug events in the acute setting.
  • The challenges associated with treating concomitant heart failure in older adults.

« Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure

Editorial Board member Jay Shubrook talks to treatment individualization specialist David Strain about the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:40).


Learning points include:

  • The ways in which older adults are physiologically distinct from other populations and considerations for appropriate care based on anticipated lifestyle.
  • Expectations for systolic and diastolic blood pressure changes in older adults as well as the impacts they have on cardiovascular health.
  • The importance of specific measures including: pulse pressure, arterial compliance.
  • Risk factors associated with low diastolic blood pressure (<75mmHg) and prospective antihypertensive treatment strategies that may mitigate such risks.

 

« Video 3: When to intervene in patients with diabetes and high blood pressure?



Video 5: Diabetes and blood pressure in the elderly: Which medications to use when; tips for achieving target »