Teacher:Given a passage with a context and an answer, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.
Teacher: Now, understand the problem? Solve this instance: Context: the use of antihypertensive medication in older people in order to prevent cardiovascular events is well established. The use of such agents has been encouraged by incentive schemes in the United Kingdom including the Quality and Outcomes Framework. In addition, many guidelines recommend good blood pressure (BP) control in the elderly. However, in older people antihypertensives can cause adverse effects related to hypotension.', 'the aim of this study was to assess the prevalence of lowBP and impact on outcomes, particularly in the presence of antihypertensive treatment, in a primary care population of older people.', 'a retrospective observational cohort study in people over the age of 70 years registered with primary care providers in Kent.', 'a total of 11,167 patients over 70 years old were analysed, 6,373 female (57%). Systolic blood pressure (SBP) was below 120 mmHg in 1,297 people (844 on antihypertensives), below 110 mmHg in 474 (313 on antihypertensives) and below 100 mmHg in 128 (89 on antihypertensives). Hypotension was independently associated with mortality, acute kidney injury and hospital admission.
Answer: the results demonstrate that low SBP is associated with adverse events, it is possible that the pursuit ofBP control at a population level may lead to over-treatment in certain groups of patients. This may result in an increased incidence of adverse events particularly in older people.
Student:
Do older people remain on blood pressure agents despite being hypotensive resulting in increased mortality and hospital admission?