|
KMID : 1143420210140211422
|
|
Public Health Weekly Report
2021 Volume.14 No. 21 p.1422 ~ p.1433
|
|
|
Establishment of an optimal management strategy for older patients with hypertension
|
|
Choi Jung-Yeon
Kim Kwang-Il
Park Ji-Hye
Park Ji-Hye
Lee Seung-Hee
Kim Won-Ho
|
|
|
Abstract
|
|
|
It has been estimated that a quarter of the adults worldwide have hypertension and this rate is expected to go up with the
increased risk of cardiovascular and cerebrovascular disease. In addition, with the world population aging, the prevalence of hypertension is expected to increase. There is a lot of evidence supporting the benefit of anti-hypertensive treatment
among older adults, but the optimal target blood pressure for hypertension in older adults is uncertain, especially among
patients with multimorbidity and frailty. This study conducted the ‘HOW to Optimize eLDerly systolic Blood Pressure’
(HOWOLD-BP) trial study. The aim of the trial was to evaluate whether an intensive treatment (systolic blood pressure ≤ 130 mmHg) provides more benefits in lowering cardiovascular events than a standard treatment (systolic blood pressure ≤140 mmHg) in older hypertensive patients aged at 65 years and over. HOWOLD-BP was a multi-center, parallel-design, singleblinding randomized controlled trial aimed at eleven national hospitals throughout Korea that will be recruited participants and will be enrolled 3,176 older adults with hypertension into the trial. Eligible patients will be evaluated at baseline for sociodemographic status, personal and family history, orthostatic blood pressure, frailty status, physical and cognitive function, and quality of life. The patients will be measured every 3 months for the first year and every 6 months till 36 months. The primary outcome is a composite of the new development of cardiovascular disease (CVD), such as acute
coronary syndrome, stroke, and heart failure; and the additional outcomes are death from CVD, hospitalization due to CVD,
and quality of life. The HOWOLD-BP trial will provide evidence of the optimal target of blood pressure control for reducing
cardiovascular disease among older Korean adults with hypertension. In addition, the trial’s results will be helpful in
developing a customized management model considering the characteristics of elderly hypertensive patients in Korea and
improving the treatment guidelines.
|
|
|
KEYWORD
|
|
|
Older adults, Hypertension, Cardiovascular disease, Cognitive function, Physical function, Frailty
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|