Clinical outcomes with a systolic blood pressure lower than 120 mmHg in older patients with high disease burden
Background: The target blood pressure in older patients is controversial. Recent studies provided clinical evidence supporting a target systolic blood pressure 50 years at high risk of cardiovascular events. Methods: Retrospective study of 380 consecutive patients ≥60 years with stages 1-5 pre-dialy...
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| Veröffentlicht in: | Renal failure 2016-10, Vol.38 (9), p.1364-1369 |
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| container_title | Renal failure |
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| creator | Franco Palacios, Carlos R. Haugen, Eric N. Thompson, Amanda M. Rasmussen, Richard W. Goracke, Nathan Goyal, Pankaj |
| description | Background: The target blood pressure in older patients is controversial. Recent studies provided clinical evidence supporting a target systolic blood pressure 50 years at high risk of cardiovascular events.
Methods: Retrospective study of 380 consecutive patients ≥60 years with stages 1-5 pre-dialysis chronic kidney disease seen between January 2013 and November 2015. The outcomes of a systolic blood pressure |
| doi_str_mv | 10.1080/0886022X.2016.1227924 |
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Methods: Retrospective study of 380 consecutive patients ≥60 years with stages 1-5 pre-dialysis chronic kidney disease seen between January 2013 and November 2015. The outcomes of a systolic blood pressure <120 mmHg in older patients with chronic kidney disease and multiple comorbidities were analyzed.
Results: Sixty-eight patients had a systolic blood pressure <120 mmHg, 312 patients had a systolic blood pressure ≥120 mmHg. Forty-three patients died during the follow up (11.3%). Patients with a systolic blood pressure <120 mmHg had a higher risk of death: 21 (30.9%) vs 22 (7%).
Primary cause of death: Cardiovascular: 11 (25.6%), infectious 9 (20.9%), cancer 5 (11.6%), renal failure 6 (13.9%), COPD/pulmonary fibrosis 2 (4.6%), end stage liver disease 3 (6.9%), traumatic brain injury 1 (2.3%), gastrointestinal hemorrhage 4 (9.3%), complications of diabetes 1 (2.3%), unknown 1 (2.3%). After adjusting for confounding factors, a systolic blood pressure <120 mmHg remained associated with increased mortality. There was a trend to more cardiovascular outcomes in those with a lower blood pressure.
Conclusions: A systolic blood pressure below 120 mmHg in older patients with high disease burden was associated with adverse outcomes. Individualization of blood pressure therapy to each specific patient is warranted.</description><identifier>ISSN: 0886-022X</identifier><identifier>EISSN: 1525-6049</identifier><identifier>DOI: 10.1080/0886022X.2016.1227924</identifier><identifier>PMID: 27607547</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Aged ; Blood Pressure - physiology ; cardiovascular disease ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - physiopathology ; Cause of Death - trends ; chronic kidney disease ; elderly ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; Incidence ; Male ; Middle Aged ; outcomes ; Prevalence ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - physiopathology ; Retrospective Studies ; Risk Factors ; Survival Rate - trends ; United States - epidemiology</subject><ispartof>Renal failure, 2016-10, Vol.38 (9), p.1364-1369</ispartof><rights>2016 Informa UK Limited, trading as Taylor & Francis Group 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3284-4c19fc4ba06848e1c33dcfebe74edb48d6b4c0b1f2991ceb92e126e12b3e675c3</citedby><cites>FETCH-LOGICAL-c3284-4c19fc4ba06848e1c33dcfebe74edb48d6b4c0b1f2991ceb92e126e12b3e675c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27607547$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Franco Palacios, Carlos R.</creatorcontrib><creatorcontrib>Haugen, Eric N.</creatorcontrib><creatorcontrib>Thompson, Amanda M.</creatorcontrib><creatorcontrib>Rasmussen, Richard W.</creatorcontrib><creatorcontrib>Goracke, Nathan</creatorcontrib><creatorcontrib>Goyal, Pankaj</creatorcontrib><title>Clinical outcomes with a systolic blood pressure lower than 120 mmHg in older patients with high disease burden</title><title>Renal failure</title><addtitle>Ren Fail</addtitle><description>Background: The target blood pressure in older patients is controversial. Recent studies provided clinical evidence supporting a target systolic blood pressure <120 mmHg in patients >50 years at high risk of cardiovascular events.
Methods: Retrospective study of 380 consecutive patients ≥60 years with stages 1-5 pre-dialysis chronic kidney disease seen between January 2013 and November 2015. The outcomes of a systolic blood pressure <120 mmHg in older patients with chronic kidney disease and multiple comorbidities were analyzed.
Results: Sixty-eight patients had a systolic blood pressure <120 mmHg, 312 patients had a systolic blood pressure ≥120 mmHg. Forty-three patients died during the follow up (11.3%). Patients with a systolic blood pressure <120 mmHg had a higher risk of death: 21 (30.9%) vs 22 (7%).
Primary cause of death: Cardiovascular: 11 (25.6%), infectious 9 (20.9%), cancer 5 (11.6%), renal failure 6 (13.9%), COPD/pulmonary fibrosis 2 (4.6%), end stage liver disease 3 (6.9%), traumatic brain injury 1 (2.3%), gastrointestinal hemorrhage 4 (9.3%), complications of diabetes 1 (2.3%), unknown 1 (2.3%). After adjusting for confounding factors, a systolic blood pressure <120 mmHg remained associated with increased mortality. There was a trend to more cardiovascular outcomes in those with a lower blood pressure.
Conclusions: A systolic blood pressure below 120 mmHg in older patients with high disease burden was associated with adverse outcomes. Individualization of blood pressure therapy to each specific patient is warranted.</description><subject>Aged</subject><subject>Blood Pressure - physiology</subject><subject>cardiovascular disease</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - physiopathology</subject><subject>Cause of Death - trends</subject><subject>chronic kidney disease</subject><subject>elderly</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>outcomes</subject><subject>Prevalence</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Survival Rate - trends</subject><subject>United States - epidemiology</subject><issn>0886-022X</issn><issn>1525-6049</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kL1u2zAURokiQeO6fYQGHLPIJSmKorYURlIHMNAlBboR_LmyWVCiTUowvGXta-ZJIsNOxw4Xd7jn-y5wEPpKyYISSb4RKQVh7PeCESoWlLG6YfwDmtGKVYUgvLlCsxNTnKAb9CnnP4TQStbsI7phtSB1xesZ2i-D773VAcdxsLGDjA9-2GKN8zEPMXiLTYjR4V2CnMcEOMQDJDxsdY8pI68vf7tutcG-xzG46bDTg4d-uNRs_WaLnc-gM2AzJgf9Z3Td6pDhy2XP0a_Hh-flqlj__PG0_L4ubMkkL7ilTWu50URILoHasnS2BQM1B2e4dMJwSwxtWdNQC6ZhQJmYxpQg6sqWc3R37t2luB8hD6rz2UIIuoc4ZkVlKWomq6aZ0OqM2hRzTtCqXfKdTkdFiTrZVu-21cm2utiecreXF6PpwP1LveudgPsz4Ps2pk4fYgpODfoYYmqT7q3Pqvz_jzfK1pFh</recordid><startdate>20161020</startdate><enddate>20161020</enddate><creator>Franco Palacios, Carlos R.</creator><creator>Haugen, Eric N.</creator><creator>Thompson, Amanda M.</creator><creator>Rasmussen, Richard W.</creator><creator>Goracke, Nathan</creator><creator>Goyal, Pankaj</creator><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20161020</creationdate><title>Clinical outcomes with a systolic blood pressure lower than 120 mmHg in older patients with high disease burden</title><author>Franco Palacios, Carlos R. ; Haugen, Eric N. ; Thompson, Amanda M. ; Rasmussen, Richard W. ; Goracke, Nathan ; Goyal, Pankaj</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3284-4c19fc4ba06848e1c33dcfebe74edb48d6b4c0b1f2991ceb92e126e12b3e675c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Blood Pressure - physiology</topic><topic>cardiovascular disease</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - physiopathology</topic><topic>Cause of Death - trends</topic><topic>chronic kidney disease</topic><topic>elderly</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>outcomes</topic><topic>Prevalence</topic><topic>Renal Insufficiency, Chronic - complications</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Survival Rate - trends</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Franco Palacios, Carlos R.</creatorcontrib><creatorcontrib>Haugen, Eric N.</creatorcontrib><creatorcontrib>Thompson, Amanda M.</creatorcontrib><creatorcontrib>Rasmussen, Richard W.</creatorcontrib><creatorcontrib>Goracke, Nathan</creatorcontrib><creatorcontrib>Goyal, Pankaj</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Renal failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Franco Palacios, Carlos R.</au><au>Haugen, Eric N.</au><au>Thompson, Amanda M.</au><au>Rasmussen, Richard W.</au><au>Goracke, Nathan</au><au>Goyal, Pankaj</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes with a systolic blood pressure lower than 120 mmHg in older patients with high disease burden</atitle><jtitle>Renal failure</jtitle><addtitle>Ren Fail</addtitle><date>2016-10-20</date><risdate>2016</risdate><volume>38</volume><issue>9</issue><spage>1364</spage><epage>1369</epage><pages>1364-1369</pages><issn>0886-022X</issn><eissn>1525-6049</eissn><abstract>Background: The target blood pressure in older patients is controversial. Recent studies provided clinical evidence supporting a target systolic blood pressure <120 mmHg in patients >50 years at high risk of cardiovascular events.
Methods: Retrospective study of 380 consecutive patients ≥60 years with stages 1-5 pre-dialysis chronic kidney disease seen between January 2013 and November 2015. The outcomes of a systolic blood pressure <120 mmHg in older patients with chronic kidney disease and multiple comorbidities were analyzed.
Results: Sixty-eight patients had a systolic blood pressure <120 mmHg, 312 patients had a systolic blood pressure ≥120 mmHg. Forty-three patients died during the follow up (11.3%). Patients with a systolic blood pressure <120 mmHg had a higher risk of death: 21 (30.9%) vs 22 (7%).
Primary cause of death: Cardiovascular: 11 (25.6%), infectious 9 (20.9%), cancer 5 (11.6%), renal failure 6 (13.9%), COPD/pulmonary fibrosis 2 (4.6%), end stage liver disease 3 (6.9%), traumatic brain injury 1 (2.3%), gastrointestinal hemorrhage 4 (9.3%), complications of diabetes 1 (2.3%), unknown 1 (2.3%). After adjusting for confounding factors, a systolic blood pressure <120 mmHg remained associated with increased mortality. There was a trend to more cardiovascular outcomes in those with a lower blood pressure.
Conclusions: A systolic blood pressure below 120 mmHg in older patients with high disease burden was associated with adverse outcomes. Individualization of blood pressure therapy to each specific patient is warranted.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>27607547</pmid><doi>10.1080/0886022X.2016.1227924</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Alma/SFX Local Collection |
| subjects | Aged Blood Pressure - physiology cardiovascular disease Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology Cardiovascular Diseases - physiopathology Cause of Death - trends chronic kidney disease elderly Female Glomerular Filtration Rate Humans Hypertension Incidence Male Middle Aged outcomes Prevalence Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - physiopathology Retrospective Studies Risk Factors Survival Rate - trends United States - epidemiology |
| title | Clinical outcomes with a systolic blood pressure lower than 120 mmHg in older patients with high disease burden |
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