BACKGROUND: The treatment of older @entity1 with @entity101 has been controversial-in addition to uncertainty regarding appropriate blood pressure (BP) targets in the very old, there are concerns that excessive BP lowering could result in adverse events such as falls, @entity64 , and @entity73 . The @entity101 in the Very Elderly Trial (HYVET), however, found that lowering BP in @entity1 aged > or =80 years was associated with decreased morbidity and mortality. OBJECTIVE: This study compared the findings of HYVET with data from a population of elderly outpatients with @entity101 in a clinical practice setting. METHODS: This was a retrospective study of prospectively collected data from @entity1 aged > or =80 years with a history of @entity101 who visited a geriatric diagnostic day clinic in the Netherlands in 2004. The data were analyzed to determine how many @entity1 were being prescribed antihypertensive medication, how many would have been eligible for HYVET, how many achieved adequate BP control, and whether reaching BP goals was associated with the number and type of antihypertensive medications received or with eligibility for HYVET. RESULTS: During 2004, 518 @entity1 aged > or =80 years visited the geriatric diagnostic day clinic, of whom 147 met the criteria for inclusion in this study. One hundred forty-one @entity1 (95.9%) were receiving antihypertensive medication, although only 52 (35.4%) would have been eligible for HYVET. @entity303 , which was an exclusion criterion in HYVET, was the major reason for ineligibility (70 [47.6%]). Greater proportions of @entity1 in this study had comorbidities compared with the HYVET population ( @entity64 : 22.4% vs 6.7%, respectively; @entity583 : 7.5% vs 3.1%; @entity712 : 11.6% vs 2.9%; @entity6 : 21.1% vs 6.8%). At the time of the clinic visit, 50.3% of @entity1 had adequate BP control, as defined in HYVET (systolic BP <150 mm Hg and diastolic BP <80 mm Hg). Levels of BP control were similar in @entity1 who would and would not have been ineligible for HYVET. Only the mean (SD) number of antihypertensive medications received was significantly associated with the achievement of BP control compared with failure to achieve adequate BP control (2.2 [1.0] vs 1.8 [1.1], respectively; P < 0.05). CONCLUSIONS: Based on the findings of this study, the benefits of treating elderly @entity1 with @entity101 in clinical practice may be lower than those reported by HYVET. The study results support the current recommendation that all @entity1 with @entity101 should be treated with >1 antihypertensive medication if adequate control is not achieved at low doses of a single medication.

Treatment of XXXX in an elderly outpatient population in the Netherlands.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension', 'Hypertension'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes mellitus'] @entity303 :: ('MESH:D003704', 'Disease') :: ['Dementia'] @entity73 :: ('MESH:D003072', 'Disease') :: ['cognitive problems'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction']
@entity101 :: (MESH:D006973,Disease) :: ['hypertension']
