Treatment of high blood pressure and residents of retirement homes



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Although 27% of all seniors living in retirement homes in this country suffer from hypertension and dementia, we still have not enough research to inform health care providers about the best how to treat their hypertension.

In particular, we do not know when the benefits of taking blood pressure lowering medications outweigh the potential risks, especially in elderly people with moderate to severe dementia and poor prognosis (medical term for Probable course of the disease). Indeed, clinical trials on high blood pressure treatments do not usually include older people with serious chronic illnesses or disabilities.

A team of researchers has designed a study to find out about the best high blood pressure treatments for seniors living in retirement homes. Their study was published Journal of the American Geriatrics Society.

The research team used the information from the Medicare records. The team identified 255,670 residents of long-term care homes in the United States in 2013 who were suffering from hypertension. Of these, almost half had thinking and decision-making difficulties related to moderate or severe dementia. A little over half of them had no or little cognitive impairment.

The participants in the study were about 85 years old on average. They had a moderate impairment of their physical function and about 3% of them received palliative care or had a life expectancy of six months or less.

At the beginning of the study, participants received treatment for hypertension.

The most commonly prescribed medications for high blood pressure were beta-blockers, followed by calcium channel blockers and angiotensin converting enzyme (ACE) inhibitors. Nearly half of participants took more than one medication for hypertension.

After following the participants for 180 days, the researchers learned that residents taking more medications for hypertension (more intensive treatment) were slightly more likely to be hospitalized or hospitalized for heart disease. than those taking less medicine for hypertension. However, they were slightly less likely to experience a decrease in their physical abilities than residents taking fewer medications for hypertension. This was true whether residents have dementia or not.

The researchers said the results of their study suggest that residents of long-term care homes with high blood pressure do not reap significant benefits from more intensive treatment. "Seniors and their caregivers should know that an intensive treatment of high blood pressure might not be helpful for residents of long-term care homes." It is reasonable to consider reducing the dose these drugs or stop their use in residents with dementia, so is consistent with their goals of care. "

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This summary is from "Treatment of Hypertension Among Residents of Long-Term Care Homes in the United States With and Without Dementia". It appears online before printing in the Journal of the American Geriatrics Society. The authors of the study are Kenneth S. Boockvar, MD; Wei Song, MA; Sei Lee, MD; and Orna Intrator, PhD.

About the Health in Aging Foundation

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national nonprofit organization established in 1999 by the American Geriatrics Society in an effort to bring the public the knowledge and expertise of geriatric health professionals. We are committed to ensuring that people are empowered to advocate for high quality care by providing reliable information and reliable resources. Last year, we reached our resources at nearly one million people through HealthinAging.org. We also help train current and future geriatric leaders by supporting opportunities to attend educational events and increasing exposure to the principles of excellence on elder care. For more information or to support the work of the Foundation, visit http: // www.HealthinAgingFoundation.org.

About Journal of the American Geriatrics Society

Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging ideas on the principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most influential publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.

About the American Geriatrics Society

Founded in 1942, the American Geriatrics Society (AGS) is a national society of geriatric health professionals, nonprofit, which has been working for 75 years to improve health, health and wellness. independence and quality of life of the elderly. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family physicians, medical badistants, pharmacists and internists. The Society provides leadership to health professionals, policy makers and the public by implementing and advocating for patient care, research, professional and public education and public policy programs. For more information, visit AmericanGeriatrics.org.

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