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BELGIUM 27th !!! 1) HTA DE GRADE 3 = TOUJOURS RISQUE > ELEVE 4 - - PowerPoint PPT Presentation
BELGIUM 27th !!! 1) HTA DE GRADE 3 = TOUJOURS RISQUE > ELEVE 4 - - PowerPoint PPT Presentation
BELGIUM 27th !!! 1) HTA DE GRADE 3 = TOUJOURS RISQUE > ELEVE 4 3 2) PREVENTION SECONDAIRE ou DIABETE + ATTEINTE ORGANE CIBLE/FACTEUR DE RISQUE = RISQUE ELEVE PEU IMPORTE LA PA 3) Si PAS >140 et/ou 90 mmHg et >3 facteurs de
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1) HTA DE GRADE 3 = TOUJOURS RISQUE > ELEVE
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2) PREVENTION SECONDAIRE ou DIABETE + ATTEINTE ‘ORGANE CIBLE’/FACTEUR DE RISQUE
= RISQUE ELEVE PEU IMPORTE LA PA
4 3
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3) Si PAS >140 et/ou 90 mmHg et
- >3 facteurs de risque CV
- ou atteinte ‘organe cible’
- ou diabète
= RISQUE ELEVE
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LI LIFE E EXPECTANCY A AT 60 Y YRS I IN 2012
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Ph van de Borne, L Missault, A Persu, W Van Mieghem for the COME STAI INVESTIGATORS
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Param eters
> 2
m edications
1
m edication m edication
Systolic BP (m m Hg)
139±19 139±18 143±21*
Diastolic BP (m m Hg)
8 0 ±11 8 1±11 8 3±13*
Age (years)
68 ±12 62±13 55±15*
Heart rate (bpm )
72±10 73±9 75±10 *
Body m ass index (kg/ m ² )
29.0 ±5.8 27.2±5.0 26.7±5.2*
S: systolic; D: diastolic; BP: Blood pressure; bpm: beat per minute; * p<0.0001
RESULTS (2): Nr of medications reported in n:7961 patients (0 vs. 1 vs. 2 or more drugs)
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Less intense treatm ent in the elderly :
Among 495 patients aged ≥80 years, and SBP> 140 mmHg, therapy was intensified: in 57% when SBP > 160 mmHg (n=130) in 17% when 140 <SBP<159 mmHg* (n=365)
*p Chi² <0.0001
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Blood pressure in m m Hg ESH/ ESC 20 13[3] ASH/ ISH 20 14 [4] Go A. et al. AHA/ ACC/ CDC 20 13 [5] 20 14 Hypertension guidelines, US “JNC 8 ” [6] Definition of Hypertension ≥140/90 ≥140/90 ≥140/90 Not addressed Drug therapy in low risk patients after non- pharm acologic treatm ent ≥140/90 ≥140/90 ≥140/90 < 60 y. ≥140/90 ≥ 60 y. ≥150/90 Beta-blockers as first line drug Yes No (Step 4) No (Step 3) No (Step 4) Diuretic thiazides chlorthalidone, indapam ide thiazides chlorthalidone indapam ide thiazides thiazides chlorthalidone, indapam ide Initiate drug therapy with two drugs If m arkedly elevated BP ≥160/100 ≥160/100 ≥160/100 Blood pressure targets <140 / 90 Elderly < 8 0 y. SBP 140 -150 SBP <140 in fit patients Elderly ≥ 80 y. SBP 140 -150 <140 / 90 ≥ 80 y. < 150 / 90 <140 / 90 Lower targets m ay be appropriate in som e patients, including the elderly < 60 y. <140 / 90 ≥ 60 y. <150/90 Blood Pressure target in patients with diabetes m ellitus < 140 / 8 5 <140 / 90 <140 / 90 Lower targets m ay be considered <140 / 90
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