Antihypertensive treatment in people of very old age with frailty: time for a paradigm shift?

Shantsila, Eduard ORCID: 0000-0002-2429-6980, Lip, Gregory YH ORCID: 0000-0002-7566-1626, Shantsila, Alena ORCID: 0000-0002-0594-8576, Kurpas, Donata, Beevers, Gareth, Gill, Paramjit S and Williams, Nefyn H ORCID: 0000-0002-8078-409X (2023) Antihypertensive treatment in people of very old age with frailty: time for a paradigm shift? Journal of Hypertension, 4 (10). pp. 1502-1510.

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Abstract

The optimal management of hypertension in individuals aged 80 years or older with frailty remains uncertain due to multiple gaps in evidence. Complex health issues, polypharmacy, and limited physiological reserve make responding to antihypertensive treatments unpredictable. Patients in this age group may have limited life expectancy, so their quality of life should be prioritized when making treatment decisions. Further research is needed to identify which patients would benefit from more relaxed blood pressure targets and which antihypertensive medications are preferable or should be avoided. A paradigm shift is required in attitudes towards treatment, placing equal emphasis on deprescribing and prescribing when optimizing care. This review discusses the current evidence on managing hypertension in individuals aged 80 years or older with frailty, but further research is essential to address the gaps in knowledge and improve the care of this population.

Item Type:	Article
Uncontrolled Keywords:	blood pressure, deprescribing, frailty, hypertension, old age
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	21 Jul 2023 13:36
Last Modified:	11 Oct 2023 14:09
DOI:	10.1097/hjh.0000000000003495
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3171818