The optimal blood pressure target in old and very old patients with hypertension.
Background With the rise in older population globally, the optimal blood pressure (BP) target for antihypertensive therapy in those aged 60 and above remains to be evaluated in the real-world practice. This study evaluated the effectiveness and safety of standard versus lower BP targets in old (aged...
| Publicado en: | Age & Ageing Vol. 55; no. 6; pp. 1 - 12 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Jun2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195099716&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195099716 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jun2026 vid: 55 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195099716 10.1093/ageing/afag167 ppf: 1 ppct: 11 formats: tig: atl: The optimal blood pressure target in old and very old patients with hypertension. aug: au: Zhang, Ran Lam, Ivan Chun Hang Liu, Xinyi Sun, Feng Zhan, Siyan Yiu, Kai Hang Chui, Celine Sze Ling Chan, Esther Wai Yin Wong, Ian Chi Kei Lam, Cindy Lo Kuen affil: Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China Pharmaco- and Device Epidemiology, Health Data Sciences, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, OX3 7LD, United Kingdom Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, ChinaKey Laboratory of Epidemiology of Major Diseases, Ministry of Education, Peking University, No. 38 Xueyuan Road, Haidian District, Beijing 100191, China Cardiology Division, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, No. 102 Pokfuam Road, Pokfulam, Hong Kong Special Administrative Region, ChinaCardiology Division, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, No. 1 Haiyuan First Road, Futian District, Shenzhen, ChinaThe Institute of Cardiovascular Science and Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. 102 Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, ChinaSchool of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, China Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, ChinaDepartment of Pharmacy, The University of Hong Kong-Shenzhen Hospital, No. 1 Haiyuan First Road, Futian District, Shenzhen, ChinaShenzhen Institute of Research and Innovation, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, ChinaAston Pharmacy School, Aston University, Birmingham, B4 7ET, United KingdomSchool of Pharmacy, Macau University of Science and Technology, Avenida Wii Long, Taipa, Macau Special Administrative Region, ChinaAdvanced Data Analytics for Medical Science (ADAMS) Limited, No. 19 Science Park West Avenue, Hong Kong Special Administrative Region, China Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. 21 Sassoon Road, Pokfulam, Hong Kong Special Administrative Region, ChinaDepartment of Family Medicine, The University of Hong Kong-Shenzhen Hospital, No. 1 Haiyuan First Road, Futian District, Shenzhen, China su: Hong Kong (China) Hypertension Aging Old age Cardiovascular disease prevention Risk assessment Statistical hypothesis testing Scientific observation Logistic regression analysis Major adverse cardiovascular events Antihypertensive agents Descriptive statistics Cardiovascular diseases risk factors Electronic health records Blood pressure Ambulatory blood pressure monitoring Data analysis software Confidence intervals Blood pressure measurement Sensitivity & specificity (Statistics) Nonparametric statistics sug: subj: Hypertension Aging Old age Hong Kong (China) All Other Miscellaneous Ambulatory Health Care Services Pharmaceutical and medicine manufacturing Cardiovascular disease prevention Risk assessment Statistical hypothesis testing Scientific observation Logistic regression analysis Major adverse cardiovascular events Antihypertensive agents Descriptive statistics Cardiovascular diseases risk factors Electronic health records Blood pressure Ambulatory blood pressure monitoring Data analysis software Confidence intervals Blood pressure measurement Sensitivity & specificity (Statistics) Nonparametric statistics keyword: adverse event aged antihypertension management antihypertensive agents blood pressure cardiovascular diseases chronic copyrightHolder:British Geriatrics Society copyrightYear:2026 hong kong https://dx.doi.org/10.1093/ageing/afag167 hypertension inLanguage:en kidney failure mortality older patients publisher:Oxford University Press safety sameAs:https://pubmed.ncbi.nlm.nih.gov/42258778/ adverse event aged antihypertension management antihypertensive agents blood pressure cardiovascular diseases chronic copyrightHolder:British Geriatrics Society copyrightYear:2026 hong kong https://dx.doi.org/10.1093/ageing/afag167 hypertension inLanguage:en kidney failure mortality older patients publisher:Oxford University Press safety sameAs:https://pubmed.ncbi.nlm.nih.gov/42258778/ ab: Background With the rise in older population globally, the optimal blood pressure (BP) target for antihypertensive therapy in those aged 60 and above remains to be evaluated in the real-world practice. This study evaluated the effectiveness and safety of standard versus lower BP targets in old (aged 60–79) and very old (aged ≥80) patients with hypertension in real-world clinical settings. Methods We emulated a target trial using electronic medical records from the Hong Kong Hospital Authority, including patients aged 60 years or above with a diagnosis of hypertension, uncontrolled BP and records of antihypertensives adjustments from 2008 to 2013. Patients were first categorized into 3 age groups (60–69, 70–79, ≥ 80) and then assigned to BP targets of either 130–140/80–90 mmHg or below 130/80 mmHg. Outcomes included major cardiovascular disease (CVD), end-stage renal disease, all-cause mortality and major adverse events related to antihypertensive treatment. Results Of 132 430 eligible patients identified, 52 553, 28 661 and 7106 patients aged 60–69, 70–79 and ≥ 80 years had BP targets of 130–140/80–90 mmHg, respectively; 11 148, 5636 and 1203 of patients in the same age groups had targets below 130/80 mmHg. Lower BP target was associated with reduced overall CVD and all-cause mortality: aged 60–69 years (CVD HR: 0.91 [95% CI, 0.85–0.96]; all-cause mortality: 0.89 [0.81–0.98]), aged 70–79 years (CVD: 0.87 [0.82–0.93]; all-cause mortality: 0.84 [0.78–0.91]), and aged≥80 years (CVD: 0.77 [0.69–0.86]; all-cause mortality: 0.80 [0.72–0.89]). No significant increase in major adverse events was observed in any age group. Results were consistent across all subgroups. Conclusion Lowering BP of below 130/80 mmHg in old and very old patients was associated with better cardiovascular and mortality outcomes without increased adverse events. These findings suggest that a lower BP target may be beneficial and safe for older patients with hypertension. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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