The Effect of Antihypertensive Treatment on Target-Organ Damage in Very Elderly Patients_Chinese Journal of Evidence-Based Medicine

Authors：

LIU ZhenDong ,  LU FangHong , ZHAO YingXin , JIN Shikuan , WU Fan , ZHOU Xiaohong , YANG Jianmin

Cardio-Cerebrovascular control and Research Center Shandong Academy of Medical Sciences, Jinan 250062, China;

Corresponding author：

LU FangHong, Email: zhendongliu876@126.com

Keywords：

Hypertension; Very elderly; Target-organ damage; Anti-hypertension treatment

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Objective 　To explore the effect of antihypertensive treatment on target-organ damage in very elderly patients ( gt;80 years).
Methods 　One hundred and sixty-seven very elderly hypertensive patients were randomized into two groups, i.e. anti-hypertension treatment group and placebo-control group. All the patients received echocardiographic examination of left ventricular mass index, laboratory tests of urinary creatinine and urinary albumin and 24-hour ambulatory blood pressure monitoring 2 months after placebo washout period and at the end of the one year treatment, respectively.
Results 　After treatment, the improvement in all the dynamic blood pressure parameters except daytime diastolic blood pressure and heart rate(24 h, daytime and night time), were significantly better than that of placebo-control group(P lt;0.05).The improvement in left ventricular and renal functional parameters were significantly better than that of placebo-control group(P lt;0.05).
Conclusion 　Anti-hypertension treatment may significantly improve left ventricular pachynsis and renal function damage in very elderly hypertensive patients.

Citation： LIU ZhenDong,LU FangHong,ZHAO YingXin,JIN Shikuan,WU Fan,ZHOU Xiaohong,YANG Jianmin. The Effect of Antihypertensive Treatment on Target-Organ Damage in Very Elderly Patients. Chinese Journal of Evidence-Based Medicine, 2006, 06(7): 479-483. doi: Copy

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3.	宋现涛, 吕树铮. 动态血压检测的应用与抗高血压药物疗效评价. 心肺血管病杂志, 2001; 20(4): 246～247.
4.	钟忠辉, 刘国树, 孟凡华, 等. 原发性高血压“杓型”与“非杓型”者动态血压变异特点及其微循环改变的临床研究. 临床心电学杂志, 1998; (4): 152～155.
5.	Liu LS. Hypertension. Beijing: People’s Medical Publishing House; 2001. 492-493.
6.	Joe Duggan. Benefits of Treating Hypertension in the Elderly Should Age Affect Treatment Decisions? Drugs & Aging, 2001; 18 (9): 631-638.
7.	Elliott HL. 24-hour blood pressure control: its relevance to cardiovascular outcomes and the importance of long-acting antihypertensive drugs. J Hum Hypertens, 2004; 18(8): 539-543.
8.	O’rourke RA. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on recommendation for standardization of measurements from M-mode echocardiograms. Circulation, 1984; 69: 854A.
9.	Devereux RB. Detection of left ventricular hypertrophy by M-mode echocardiography, anatomic validation, sdandardization, and comparison to other methods. Hypertension, 1987; 9(suppl Ⅱ): 19-26.
10.	Cianán O’Sullivan; Joe Duggan; Simon Lyons; et al. Hypertensive Target-Organ Damage in the Very Elderly. Hypertension, 2003; 42: 130.
11.	Li JX, Liu J, Chen WW, et al. Clinical significance of circadian blood pressure changes in patients with essential hypertension. J Clin Electrocardiol, 2000; (2): 76-77.
12.	Song XT, Lv SZ. Evaluation of ambulatory blood pressure monitoring application and effect of anti-hypertension medicine. Journal of Cardiovascular & Pulmonary Diseases, 2001; 20(4): 246-247.
13.	Zhong ZH, Liu GS, Meng FH, et al. 24h ambulatory blood pressure variability (ABPV) character and microcirculation change in “dippers” and “non-dippers” in mild to moderate hypertension. Journal of Clinical Electrocardiology, 1998; (4): 152-155.
14.	Boshuizen HC, Izaks GJ, van Buuren S, et al. Blood pressure and mortality in elderly people aged 85 and older: community based study. BMJ, 1998; 316: 1780-1784.
15.	Satish S, Freeman DH, Ray L, et al. The relationship between blood pressure and mortality in the oldest old. J Am Geriatr Soc, 2001; 49: 367–374.

1. 刘力生. 高血压. 北京: 人民卫生出版社; 2001. 492～493.
2. 李景霞, 刘军, 陈卫文, 等. 原发性高血压病患者血压昼夜节律的临床意义探讨. 临床心电学杂志, 2000; (2): 76～77.
3. 宋现涛, 吕树铮. 动态血压检测的应用与抗高血压药物疗效评价. 心肺血管病杂志, 2001; 20(4): 246～247.
4. 钟忠辉, 刘国树, 孟凡华, 等. 原发性高血压“杓型”与“非杓型”者动态血压变异特点及其微循环改变的临床研究. 临床心电学杂志, 1998; (4): 152～155.
5. Liu LS. Hypertension. Beijing: People’s Medical Publishing House; 2001. 492-493.
6. Joe Duggan. Benefits of Treating Hypertension in the Elderly Should Age Affect Treatment Decisions? Drugs & Aging, 2001; 18 (9): 631-638.
7. Elliott HL. 24-hour blood pressure control: its relevance to cardiovascular outcomes and the importance of long-acting antihypertensive drugs. J Hum Hypertens, 2004; 18(8): 539-543.
8. O’rourke RA. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on recommendation for standardization of measurements from M-mode echocardiograms. Circulation, 1984; 69: 854A.
9. Devereux RB. Detection of left ventricular hypertrophy by M-mode echocardiography, anatomic validation, sdandardization, and comparison to other methods. Hypertension, 1987; 9(suppl Ⅱ): 19-26.
10. Cianán O’Sullivan; Joe Duggan; Simon Lyons; et al. Hypertensive Target-Organ Damage in the Very Elderly. Hypertension, 2003; 42: 130.
11. Li JX, Liu J, Chen WW, et al. Clinical significance of circadian blood pressure changes in patients with essential hypertension. J Clin Electrocardiol, 2000; (2): 76-77.
12. Song XT, Lv SZ. Evaluation of ambulatory blood pressure monitoring application and effect of anti-hypertension medicine. Journal of Cardiovascular & Pulmonary Diseases, 2001; 20(4): 246-247.
13. Zhong ZH, Liu GS, Meng FH, et al. 24h ambulatory blood pressure variability (ABPV) character and microcirculation change in “dippers” and “non-dippers” in mild to moderate hypertension. Journal of Clinical Electrocardiology, 1998; (4): 152-155.
14. Boshuizen HC, Izaks GJ, van Buuren S, et al. Blood pressure and mortality in elderly people aged 85 and older: community based study. BMJ, 1998; 316: 1780-1784.
15. Satish S, Freeman DH, Ray L, et al. The relationship between blood pressure and mortality in the oldest old. J Am Geriatr Soc, 2001; 49: 367–374.

Chinese Journal of Evidence-Based Medicine

The Effect of Antihypertensive Treatment on Target-Organ Damage in Very Elderly Patients

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