Antihypertensive overtreatment in people 80 years old and older
Copyright © 2017 Elsevier España, S.L.U. All rights reserved..
BACKGROUND AND OBJECTIVE: To study the proportion of patients older than 80 years old with hypertension and pharmacological overtreatment.
PATIENTS AND METHODS: Cross-sectional simulation study, including 281 patients older than 80 years old of primary prevention, randomly selected, with good control of hypertension (systolic blood pressure<150mmHg, diastolic blood pressure<90mmHg), treated with a maximum of 3 medications. Overtreatment was considered if at least one medication could be removed and good control persisted, calculating how the blood pressure would raise with Law's meta-analysis, which estimates blood pressure reductions by pre-treatment levels, number and dose of medications.
RESULTS: The average age was 85.3 years (64.8% women). A percentage of 33.6 were taking one medication, 46.3% 2 and 22.1% 3, with the most prescribed being thiazides (69.4%), ACE inhibitors (51.3%), ARBs (23.4%), calcium antagonists (21%) and beta blockers (19.6%). Overtreatment was 90.7%, with 2 medications being able to be removed in 63.1% of cases and 3 in 43.1%. Polypharmacy (OR 2.47; 95% CI 1.07-5.69; P=.033) was associated with a greater likely removal of at least one medication.
CONCLUSIONS: The proportion of patients with overtreatment is high. Changing good control criteria could contribute to a reasoned deprescription.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:150 |
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| Enthalten in: |
Medicina clinica - 150(2018), 6 vom: 23. März, Seite 220-223 |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Sobretratamiento antihipertensivo en mayores de 80 años |
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| Beteiligte Personen: |
Baena Díez, José Miguel [VerfasserIn] |
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| Links: |
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| Themen: |
Ancianos |
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| Anmerkungen: |
Date Completed 09.09.2019 Date Revised 09.09.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.medcli.2017.06.061 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM275394492 |
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| 245 | 1 | 0 | |a Antihypertensive overtreatment in people 80 years old and older |
| 246 | 3 | 3 | |a Sobretratamiento antihipertensivo en mayores de 80 años |
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| 500 | |a Date Revised 09.09.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a BACKGROUND AND OBJECTIVE: To study the proportion of patients older than 80 years old with hypertension and pharmacological overtreatment | ||
| 520 | |a PATIENTS AND METHODS: Cross-sectional simulation study, including 281 patients older than 80 years old of primary prevention, randomly selected, with good control of hypertension (systolic blood pressure<150mmHg, diastolic blood pressure<90mmHg), treated with a maximum of 3 medications. Overtreatment was considered if at least one medication could be removed and good control persisted, calculating how the blood pressure would raise with Law's meta-analysis, which estimates blood pressure reductions by pre-treatment levels, number and dose of medications | ||
| 520 | |a RESULTS: The average age was 85.3 years (64.8% women). A percentage of 33.6 were taking one medication, 46.3% 2 and 22.1% 3, with the most prescribed being thiazides (69.4%), ACE inhibitors (51.3%), ARBs (23.4%), calcium antagonists (21%) and beta blockers (19.6%). Overtreatment was 90.7%, with 2 medications being able to be removed in 63.1% of cases and 3 in 43.1%. Polypharmacy (OR 2.47; 95% CI 1.07-5.69; P=.033) was associated with a greater likely removal of at least one medication | ||
| 520 | |a CONCLUSIONS: The proportion of patients with overtreatment is high. Changing good control criteria could contribute to a reasoned deprescription | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Ancianos | |
| 650 | 4 | |a Deprescripción | |
| 650 | 4 | |a Deprescription | |
| 650 | 4 | |a Elderly | |
| 650 | 4 | |a Hipertensión | |
| 650 | 4 | |a Hypertension | |
| 650 | 4 | |a Overtreatment | |
| 650 | 4 | |a Sobretratamiento | |
| 650 | 4 | |a Tratamiento y control | |
| 650 | 4 | |a Treatment and control | |
| 650 | 7 | |a Antihypertensive Agents |2 NLM | |
| 700 | 1 | |a López Maldonado, Nerea |e verfasserin |4 aut | |
| 700 | 1 | |a Navarro Guiu, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Alcayde Claveria, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a García Lareo, Manel |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez Orcero, Almudena |e verfasserin |4 aut | |
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