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Yaşlılarda hipertansiyona yaklaşım

Approach to hypertension in elderly people

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DOI: 
doi:10.2399/tahd.10.167

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Abstract (2. Language): 
Systolic blood pressure higher than 140 mmHg or diastolic blood pressure higher than 90 mmHg for people older than 65 years is called hypertension in elderly. Hypertension is frequent among elderly people (>60%) and isolated systolic hypertension (systolic blood pressure a140 mmHg or diastolic blood pressure a90 mmHg) constitutes two-third of all cases of hypertension in elderly. Hypertension of the elderly differs from younger adults. Besides endothelial changes due to aging and decrease in the left ventricu¬lar function, mechanisms of the regulation of the cerebral blood flow are more vulnerable. Thus; agressive treatments for hypertension in the elderly can be harmful. This article aims to give informa¬tion about detection, treatment and differences of the hypertension in the elderly population.
Abstract (Original Language): 
Yaşlıda hipertansiyon, 65 yaşın üzerinde, sistolik kan basıncının 140 mmHg'nın ya da diyastolik kan basıncının 90 mmHg'nın üzerinde olması ile tanımlanır. Hipertansiyon yaşlılarda sık görülür (>%60), üçte ikisi yalnıca sistolik ya da yalnızca diastoliktir; (sistolik kan basıncı a140 mmHg ya da diyastolik kan basıncının a90 mmHg olması). Yaşlıdaki hipertansiyon diğer yaşlardaki hipertansiyondan şu özellikleriyle ayrılır: Yaşlıda, endotel değişimlerinin ve sol kalp fonksiyonu azalmasının yanısıra beyin kan akımını düzenleyen mekanizmalar da daha kırılgandır. Bu nedenle ileri yaş grubunda agre-sif yaklaşımlı tedavi yarar yerine zarar verebilir. Bu makalede yaşlı¬daki hipertansiyonun tanı ve tedavi özellikleri gözden geçirilmekte¬dir.
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REFERENCES

References: 

Beers MH, Jones TV. Hypertension. The Merck Manual of Geriatrics Online 3rd edition. http://www.merck.com/mkgr/CVMHighLight?i^le=/ mkgr/mmg/sec11/ch85/ch85a.jsp%3Fregion%3Dmerckcom&word=hype rtension&domain= www.merck.com#hl_anchor adresinden 03/09/2009 tarihinde erişilmiştir.
Rogers RL, Anderson RS Jr. Severe hypertension in the geriatric patient-is it an emergency or not? Clin Geriatr Med 2007; 23: 363-70. Chobanian AV, Bakris GL, Black HR ve ark. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA 2003; 289: 2560-72. National Center for Health Statistics. Chartbook on the Health of Americans. Hyattsville. http://www.cdc.gov/nchs/data/hus/hus08.pdf. ad¬resinden 02/08/2009 tarihinde erişilmiştir.
Cherry D, Woodwell D. National Ambulatory Medical Care Survey: 2000 summary. Adv Data 2002; 328: 1-32.
Altun B, Arici M, Nergizoğlu G ve ark. For the Turkish Society of Hypertension and Renal Diseases. Prevalence, awareness, treatment and
7.
8.
9.
10.
11.
12.
control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens
2005; 23: 1817-23.
Onat A, Keleş I, Aksu H ve ark. Türk erişkinlerinde toplam ve kardiyak ölümlerin prevalansı: TEKHARF Çalışmasının 8-yıllık takip verileri. Türk Kardiyol Dern Arş 1999; 27: 8-14.
McDonald M, Hertz RP,
Unge
r AN, Lustik MB. Prevalence, awareness, and management of hypertension, dyslipidemia, and diabetes among United States adults aged 65 and older. J Gerontol A Biol Sci Med Sci 2009;
64: 256-63.
Aguado A, Löpez F, Miravet S ve ark. Hypertension in the very old; prevalence, awareness, treatment and control: a cross-sectional popula¬tion-based study in a Spanish municipality. BMC Geriatr 2009; 9: 16. Manzato E, Romanato G, Zambon S ve ark. Metabolic syndrome and car¬diovascular disease in the elderly: the Progetto Veneto Anziani (Pro.V.A.) sttudy. Aging Clin Exp Res 2008; 20: 47-52.
Lakatta E. Cardiovascular system. Handbook of Physiology'de. Ed. Masoro E. New York, Oxford University Press, 1995; 413-74. Fleg JL. Alterations in cardiovascular structure and function with advanc¬ing age. Am J Cardiol 1986; 57: 33-44.
13. Mancia G, De Backer G, Dominiczak A ve ark. ESH/ESC 2007
Guidelines for the Management of Arterial Hypertension. J Hypertens
2007; 25: 1105-87.
Chobanian AV, BakrisGL, Black HR ve ark. The Seventh Report of the The Joint National Committee on Prevention, Detection, Evaluation,
and Treatment of High Blood Pressure. JAMA2003; 289: 2561.
Kawamoto A, Shimada K, Matsubayashi K ve ark. Cardiovascular regula¬tory functions inelderly patients with hypertension. Hypertension1989; 13:
401-7.
Messerli FG, Glade LB, Dreslinski GR ve ark. Hypertension in the eld¬erly: haemodynamic, fluid volume and endocrine findings. Clin Sci 1981;
61: 393-4.
Messerli FG, Sundgaard-Riise K, Ventura HO ve ark. Essential hyper¬tension in the elderly: haemodynamics, intravascular volume, plasma renin activity, and circulating catecholamine levels. Lancet 1983; 2: 983-6. Mukai S, Gagnon M, Iloputaife I ve ark. Effect of systolic blood pressure and carotid stiffness on baroreflex gain in elderly subjects. J Gerontol 2003;
58A: 626-30.
Saka B, Oflaz H, Erten N ve ark. Non-invasive evaluation of endothelial function in hypertensive elderly patients. Arch Gerontol Geriatr 2005; 40:
61-71.
Bisognano JD, Townsend KA, Skyles AJ, Samuels KM. Prevalence of comorbidities and their influence on blood pressure goal attainment in geriatric patients. Am J Geriatr Cardiol 2007; 16: 24-9. Safar H, Chahwakilian A, Boudali Y, Debray-Meignan S, Safar M, Blacher J. Arterial stiffness, isolated systolic hypertension, and cardiovas¬cular risk in the elderly. Am J Geriatr Cardiol 2006; 15: 178-82. 22. Vaitkevicius PV, Fleg JL, Engel JH ve ark. Effects of age and aerobic capacity on arterial stiffness in healthy adults. Circulation 1993; 88: 1456-
14.
15.
16.
17.
18.
19.
20.
21.
62.
23.
24.
Smulyan S, Safar ME. The diastolic blood pressure in systolic hyperten¬sion. Ann Intern Med 2000; 132: 233-7.
Kipshidze NN, Zubiashvili TG. Isolated systolic arterial hypertension in elderly and senile patients. Adv Gerontol 2006; 18: 66-70. 25. Eto M, Toba K, Akishita M ve ark. Impact of blood pressure variability on cardiovascular events in elderly patients with hypertension. Hypertens
Res2005; 28: 1-7.
Edwards MS, Craven TE, Burke GL, Dean RH, Hansen KJ. Renovascular disease and the risk of adverse coronary events in the elderly: a prospective, population-based study. Arch Intern Med 2005; 165: 207-13.
26.
e 3
1.
2.
3.
4.
5.
6.
Türkiye Aile Hekimliği Dergisi |
Turkish Journal of Family Practice | Cilt 14 | Sayı 4 | 2010
171
27.
28.
Kannel WB. Some lessons in cardiovascular epidemiology from Framingham. Am J Cardiol1976; 37: 269-82.
Haider AW, Larson MG, Franklin SS ve ark. Systolic blood pressure, diastolic blood pressure, and pulse pressure as predictors of risk for con¬gestive heart failure in the Framingham Heart Study. Ann Intern Med
2003; 138: 10-6.
29. Euser SM, Van Bemmel T, Schram MT ve ark. The effect of age on the association between blood pressure and cognitive function later in life. J
Am Geriatr Soc2009; 57: 1232-7.
30. Peters R, Beckett N, Forette F, ve ark. Incident dementia and blood pres¬sure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo controlled trial. Lancet Neurol 2008; 7: 683-9.
31. Hanon O, Pequignot R, Seux ML ve ark. Relationship between antihy-pertensive drug therapy and cognitive function in elderly hypertensive patients with memory complaints. J Hypertens 2006; 24: 2101-7.
32. Rea IM, Myint PK, Mueller H ve ark. Nature or nurture; BMI and blood pressure at 90. Findings from the Belfast Elderly Longitudinal Free-liv¬ing Aging Study (BELFAST). Age 2009; 31: 261-7.
Martın-Baranera
M
, Sanchez Ferrfn P, Armario P ve ark. Prevalence of hypertension in elderly long-term care residents in Spain. Med Clin (Barc)
2006; 127: 681-7.
Mendoza-Nünez
VM
, Sanchez-Rodriguez MA, Correa-Munoz E. Undernutrition and oxidative stress as risk factors for high blood pressure in older Mexican adults. Ann Nutr Metab 2009; 54: 119-23. Hazarika NC, Biswas D, Mahanta J. Hypertension in the elderly popula¬tion of Assam. J Assoc Physicians India 2003; 51: 567-73.
33.
34.
35.
36. Shankar R, Tondon J, Gambhir IS, Tripathi CB. Health status of elderly population in rural area of Varanasi district. Indian J Public Health 2007;
51: 56-8.
37. Leeper SC. Aggressive hypertension management in patients of advanc¬ing and advanced age. South Med J2005; 98: 805-8.
38. Wagner K. Specific aspects of hypertension control in the geriatric patient. MMWFortschr Med 2006; 148: 30-3.
39. Fisher AA, Davis MW, Srikusalanukul W, Budge MM. Postprandial hypotension predicts all-cause mortality in older, low-level care residents.
J Am Geriatr Soc2005; 53: 1313-20.
40. Ogihara T, Saruta T, Matsuoka H ve ark. Valsartan in elderly isolated systolic hypertension (VALISH) study: rationale and design. Hypertens Res
2004; 27: 657-61.
41. Figar S, Waisman G, De Quiros FG ve ark. Narrowing the gap in hyper¬tension: effectiveness of a complex antihypertensive program in the eld¬erly. Dis Manag2004; 7: 235-43.
42. Powers W. Acute hypertension after stroke: the scientific basis for treat¬ment decisions. Neurology1993; 43: 461-7.
43. Strandgaard S. Autoregulation of cerebral blood flow in hypertensive patients. The modifying influence of prolonged antihypertensive treat¬ment on the tolerance to acute, drug induced hypotension. Circulation
1976; 53: 720-7.
44. Strandgaard S, Paulson O. Regulation of cerebral blood flow in health and disease. J Cardiovasc Pharmacol1992; 19(Suppl 6): 89-93.
45. Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice
guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA 2005; 294: 716-24.

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