Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older
Authors: Jessica Weiss, Devan Kansagara
Journal: Annals of Internal Medicine (2017)

Letters15 August 2017Intensive Blood Pressure Treatment in Adults Aged 60 Years or OlderJessica Weiss, MD, MCR and Devan Kansagara, MD, MCRJessica Weiss, MD, MCRFrom Oregon Health & Science University and Veterans Affairs Portland Health Care System, Portland, Oregon.Search for more papers by this author and Devan Kansagara, MD, MCRFrom Oregon Health & Science University and Veterans Affairs Portland Health Care System, Portland, Oregon.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0288 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Bahat and colleagues' comments on the data available to inform blood pressure targets among frail older adults with poor functional status and multimorbidity. The 2 randomized controlled trials in our review that compared frail subgroups with nonfrail ones, SPRINT and HYVET, did identify similar benefits of lower blood pressure targets regardless of frailty status within their patient populations (1–3). We did not believe that pooling the results of these studies was statistically sound because of heterogeneous study design, patient populations, and blood pressure targets, as well as potential differences in how frailty was identified. Although ...References1. Weiss J, Kerfoot A, Freeman M, Motu’apuaka M, Fu R, Low A, et al. Benefits and harms of treating blood pressure in older adults: a systematic review and meta-analysis. VA ESP project no. 05-225. 2015. Accessed at www.hsrd.research.va.gov/publications/esp/bloodpressure.pdf on 10 February 2017. Google Scholar2. Wright JT, Williamson JD, Whelton PK, Snyder JK, Sink KM, Rocco MV, et al; SPRINT Research Group.. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015;373:2103-16. [PMID: 26551272] doi:10.1056/NEJMoa1511939 CrossrefMedlineGoogle Scholar3. Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al; HYVET Study Group. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358:1887-98. [PMID: 18378519] doi:10.1056/NEJMoa0801369 CrossrefMedlineGoogle Scholar4. Fougère B, Kelaiditi E, Hoogendijk EO, Demougeot L, Duboué M, Vellas B, et al. Frailty index and quality of life in nursing home residents: results from INCUR Study. J Gerontol A Biol Sci Med Sci. 2016;71:420-4. [PMID: 26297653] doi:10.1093/gerona/glv098 CrossrefMedlineGoogle Scholar5. Benetos A, Labat C, Rossignol P, Fay R, Rolland Y, Valbusa F, et al. Treatment with multiple blood pressure medications, achieved blood pressure, and mortality in older nursing home residents: the PARTAGE study. JAMA Intern Med. 2015;175:989-95. [PMID: 25685919] doi:10.1001/jamainternmed.2014.8012 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Oregon Health & Science University and Veterans Affairs Portland Health Care System, Portland, Oregon.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1754. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBenefits and Harms of Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older Jessica Weiss , Michele Freeman , Allison Low , Rochelle Fu , Amy Kerfoot , Robin Paynter , Makalapua Motu'apuaka , Karli Kondo , and Devan Kansagara Intensive Blood Pressure Treatment in Adults Aged 60 Years or Older Gulistan Bahat , Birkan İlhan , Asli Tufan , and Mehmet Akif Karan Metrics 15 August 2017Volume 167, Issue 4Page: 288-289KeywordsBlood pressureElderlyFrailtyHeart diseasesHeart failureMortalityMyocardial infarctionObservational studiesPopulation statisticsPrimary care ePublished: 15 August 2017 Issue Published: 15 August 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...