Blood pressure targets, medication consideration and unique concerns in elderly hypertension IV: Focus on frailty, orthostatic hypotension, and resistant hypertension
Hypertension increases the risk of cardiovascular disease in the elderly. Although treating hypertension can reduce the risk of cardiovascular disease and its related mortality, it is also challenging because these patients could have frailty, orthostatic hypotension (OH) and resistant hypertension...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-07-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S092966462400442X |
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| author | Po-Sheng Wu Chia-Ter Chao Chien-Hao Hsiao Chiu-Fen Yang Ying-Hsiang Lee Hung-Ju Lin Chih-Fan Yeh Long-Teng Lee Kuo-Chin Huang Meng-Chih Lee Cheng-Kuo Huang Yen-Hung Lin Michael Yu-Chih Chen Ding-Cheng Chan |
| author_facet | Po-Sheng Wu Chia-Ter Chao Chien-Hao Hsiao Chiu-Fen Yang Ying-Hsiang Lee Hung-Ju Lin Chih-Fan Yeh Long-Teng Lee Kuo-Chin Huang Meng-Chih Lee Cheng-Kuo Huang Yen-Hung Lin Michael Yu-Chih Chen Ding-Cheng Chan |
| author_sort | Po-Sheng Wu |
| collection | DOAJ |
| description | Hypertension increases the risk of cardiovascular disease in the elderly. Although treating hypertension can reduce the risk of cardiovascular disease and its related mortality, it is also challenging because these patients could have frailty, orthostatic hypotension (OH) and resistant hypertension (RHTN), which makes them more susceptible to treatment-related adverse events. Identifying such patients and tailoring the choice of drugs and blood pressure targets is crucial to balance the harms and benefits. The Clinical Frailty Scale is recommended to assess elderly patients with hypertension and frailty. For very frail patients, unnecessary medications should be deprescribed to avoid adverse events. Hypertension and OH frequently co-occur in the elderly, and recognizing and managing OH is essential to prevent falls and adverse events. The management of blood pressure in elderly patients with frailty, OH, and RHTN is complex, requiring the patients, their family and caregivers to be involved in decision-making to ensure that treatment plans are well-informed and aligned with the patient's needs. |
| format | Article |
| id | doaj-art-21d77eb1649e4dc5a86ee628023a1c5b |
| institution | Kabale University |
| issn | 0929-6646 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj-art-21d77eb1649e4dc5a86ee628023a1c5b2025-08-20T03:51:29ZengElsevierJournal of the Formosan Medical Association0929-66462025-07-01124S63S6910.1016/j.jfma.2024.09.022Blood pressure targets, medication consideration and unique concerns in elderly hypertension IV: Focus on frailty, orthostatic hypotension, and resistant hypertensionPo-Sheng Wu0Chia-Ter Chao1Chien-Hao Hsiao2Chiu-Fen Yang3Ying-Hsiang Lee4Hung-Ju Lin5Chih-Fan Yeh6Long-Teng Lee7Kuo-Chin Huang8Meng-Chih Lee9Cheng-Kuo Huang10Yen-Hung Lin11Michael Yu-Chih Chen12Ding-Cheng Chan13Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, TaiwanDivision of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan City, Taiwan; Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, TaiwanDepartment of Cardiology, Cardiovascular Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, TaiwanDepartment of Medicine, Mackay Medical College, Cardiovascular Center, Department of Internal Medicine, MacKay Memorial Hospital, New Taipei City, TaiwanDivision of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, TaiwanDepartment of Family Medicine, National Taiwan University Hospital & National Taiwan University, Taipei, TaiwanDepartment of Family Medicine, National Taiwan University Hospital & National Taiwan University, Taipei, TaiwanInstitute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung City, Taiwan; Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan; College of Management, Chaoyang University of Technology, Taichung, Taiwan; Study Group of Integrated Health and Social Care Project, Ministry of Health and Welfare, Taichung, TaiwanTaiwan Association of Family Medicine, Taipei, Taiwan; Dr. Cheng-Kuo Huang Clinic, Keelung, TaiwanDivision of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan; Corresponding author. Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, TaiwanDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.Hypertension increases the risk of cardiovascular disease in the elderly. Although treating hypertension can reduce the risk of cardiovascular disease and its related mortality, it is also challenging because these patients could have frailty, orthostatic hypotension (OH) and resistant hypertension (RHTN), which makes them more susceptible to treatment-related adverse events. Identifying such patients and tailoring the choice of drugs and blood pressure targets is crucial to balance the harms and benefits. The Clinical Frailty Scale is recommended to assess elderly patients with hypertension and frailty. For very frail patients, unnecessary medications should be deprescribed to avoid adverse events. Hypertension and OH frequently co-occur in the elderly, and recognizing and managing OH is essential to prevent falls and adverse events. The management of blood pressure in elderly patients with frailty, OH, and RHTN is complex, requiring the patients, their family and caregivers to be involved in decision-making to ensure that treatment plans are well-informed and aligned with the patient's needs.http://www.sciencedirect.com/science/article/pii/S092966462400442XFrailtyGeriatricOrthostatic hypotensionHypertensionResistant hypertensionAssessment |
| spellingShingle | Po-Sheng Wu Chia-Ter Chao Chien-Hao Hsiao Chiu-Fen Yang Ying-Hsiang Lee Hung-Ju Lin Chih-Fan Yeh Long-Teng Lee Kuo-Chin Huang Meng-Chih Lee Cheng-Kuo Huang Yen-Hung Lin Michael Yu-Chih Chen Ding-Cheng Chan Blood pressure targets, medication consideration and unique concerns in elderly hypertension IV: Focus on frailty, orthostatic hypotension, and resistant hypertension Journal of the Formosan Medical Association Frailty Geriatric Orthostatic hypotension Hypertension Resistant hypertension Assessment |
| title | Blood pressure targets, medication consideration and unique concerns in elderly hypertension IV: Focus on frailty, orthostatic hypotension, and resistant hypertension |
| title_full | Blood pressure targets, medication consideration and unique concerns in elderly hypertension IV: Focus on frailty, orthostatic hypotension, and resistant hypertension |
| title_fullStr | Blood pressure targets, medication consideration and unique concerns in elderly hypertension IV: Focus on frailty, orthostatic hypotension, and resistant hypertension |
| title_full_unstemmed | Blood pressure targets, medication consideration and unique concerns in elderly hypertension IV: Focus on frailty, orthostatic hypotension, and resistant hypertension |
| title_short | Blood pressure targets, medication consideration and unique concerns in elderly hypertension IV: Focus on frailty, orthostatic hypotension, and resistant hypertension |
| title_sort | blood pressure targets medication consideration and unique concerns in elderly hypertension iv focus on frailty orthostatic hypotension and resistant hypertension |
| topic | Frailty Geriatric Orthostatic hypotension Hypertension Resistant hypertension Assessment |
| url | http://www.sciencedirect.com/science/article/pii/S092966462400442X |
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