MULTIFACETED INTENSIVE BLOOD PRESSURE CONTROL MODEL IN ELDERLY PATIENTS WITH HYPERTENSION

Authors

  • I AHMAD Department of Cardiology, Timergara Teaching Hospital, Timergara Dir Lower, Pakistan
  • N IQBAL Department of Internal Medicine, MD Health Center, Lahore, Pakistan
  • ZR SHAH Department of Medicine, Surraya Bukhari Surgical Hospital, Mailsi District Vehari, Pakistan
  • A SAJJAD Department of Medicine, Hayat Memorial Hospital, Lahore, Pakistan
  • MT HASSAN Department of General Medicine and Surgery, Royal Institute of Medicine and Surgery Trauma Hospital, Karachi, Pakistan
  • H ALI Bannu Medical College, Bannu, Pakistan
  • MJ ANSARI Department of Medicine, St Joseph Hospital, Lake St Louis, United States
  • SKA RAZVI Ziauddin Medial College, Pakistan
  • A QASIM Dr. Ruth K. M. Pfau Civil Hospital, Karachi, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1269

Keywords:

Antihypertensive Agents, Blood Pressure Monitoring, Hypertension, Prospective Studies, Quality of Life

Abstract

Hypertension, a prevalent condition among older adults, is a primary risk factor for cardiovascular disease, stroke, and kidney failure. Objective: The main objective of the study is to find the multifaceted intensive blood pressure control model in elderly patients with hypertension. Methods: This prospective observational study was conducted at the Cardiology Department Timergara Teaching Hospital, Timergara Dir Lower, from January 2024 to July 2024. A total of 310 patients were included in the study. Patients aged >50 years and older and with a documented history of hypertension. Patients with terminal illness, severe cognitive impairment, or contraindications to intensive blood pressure management. Results: Data were collected from 310 patients with an average age of around 62 years and a balanced gender distribution (54% male and 46% female). The intensive and standard treatment groups had comparable baseline systolic and diastolic blood pressures (150/88 mmHg and 148/87 mmHg, respectively), indicating a uniform level of hypertension. Both groups also had similar rates of common comorbidities, including diabetes (39%), cardiovascular disease (32.5%), and chronic kidney disease (13%), which helped ensure that any treatment effects observed could be attributed to the intervention rather than underlying health differences. In the intensive group, systolic BP dropped from 150 mmHg to 118 mmHg, marking a 21% reduction, and diastolic BP decreased from 88 mmHg to 72 mmHg, a 19% reduction. In contrast, the standard group saw a 10.8% reduction in systolic BP (from 148 mmHg to 132 mmHg) and a 10.3% reduction in diastolic BP (from 87 mmHg to 78 mmHg).Conclusion: It is concluded that a multifaceted intensive blood pressure control model effectively reduces blood pressure and improves the quality of life in elderly hypertensive patients, with potential cardiovascular benefits. However, increased adverse effects in the intensive group emphasize the need for careful patient-specific adjustments and monitoring.

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References

Giovanni A, Enrico A, Aime B, Michael B, Marianne B, Jonathan C, et al. Global Burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. Journal of the American College of Cardiology. 2020;76(25):2982-3021.

Organization WH. Global report on hypertension: the race against a silent killer: World Health Organization; 2023.

Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal. 2018;39(33):3021-104.

Lancet T. Ageing in China: a ticking bomb. 2016. p. 2058.

Lancet T. Population ageing in China: crisis or opportunity? 2022. p. 1821.

Yang F, Qian D, Hu D. Prevalence, awareness, treatment, and control of hypertension in the older population: results from the multiple national studies on ageing. Journal of the American Society of Hypertension. 2016;10(2):140-8.

Li Y, Yang L, Wang L, Zhang M, Huang Z, Deng Q, et al. Burden of hypertension in China: a nationally representative survey of 174,621 adults. International journal of cardiology. 2017;227:516-23.

Schwalm J-D, McCready T, Lopez-Jaramillo P, Yusoff K, Attaran A, Lamelas P, et al. A community-based comprehensive intervention to reduce cardiovascular risk in hypertension (HOPE 4): a cluster-randomised controlled trial. The Lancet. 2019;394(10205):1231-42.

Jafar TH, Gandhi M, De Silva HA, Jehan I, Naheed A, Finkelstein EA, et al. A community-based intervention for managing hypertension in rural South Asia. New England Journal of Medicine. 2020;382(8):717-26.

He J, Irazola V, Mills KT, Poggio R, Beratarrechea A, Dolan J, et al. Effect of a community health worker–led multicomponent intervention on blood pressure control in low-income patients in Argentina: a randomized clinical trial. Jama. 2017;318(11):1016-25.

He J, Ouyang N, Guo X, Sun G, Li Z, Mu J, et al. Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP): an open-label, blinded-endpoint, cluster-randomised trial. The Lancet. 2023;401(10380):928-38.

Zhang W, Zhang S, Deng Y, Wu S, Ren J, Sun G, et al. Trial of intensive blood-pressure control in older patients with hypertension. New England Journal of Medicine. 2021;385(14):1268-79.

Williamson JD, Supiano MA, Applegate WB, Berlowitz DR, Campbell RC, Chertow GM, et al. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged≥ 75 years: a randomized clinical trial. Jama. 2016;315(24):2673-82.

Sun Y, Mu J, Wang DW, Ouyang N, Xing L, Guo X, et al. A village doctor-led multifaceted intervention for blood pressure control in rural China: an open, cluster randomised trial. The Lancet. 2022;399(10339):1964-75.

Sun Y, Li Z, Guo X, Zhou Y, Ouyang N, Xing L, et al. Rationale and design of a cluster randomized trial of a village doctor-led intervention on hypertension control in China. American Journal of Hypertension. 2021;34(8):831-9.

Inker LA, Eneanya ND, Coresh J, Tighiouart H, Wang D, Sang Y, et al. New creatinine-and cystatin C–based equations to estimate GFR without race. New England Journal of Medicine. 2021;385(19):1737-49.

Zhang YS, Hu P, Strauss JA, Zhao Y, Wang Y, Crimmins EM. Ascertaining cause of mortality among middle-aged and older persons using computer-coded and expert review verbal autopsies in the China Health and Retirement Longitudinal Study. Global Health Action. 2020;13(1):1768502.

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Published

2024-11-15

How to Cite

AHMAD, I., IQBAL, N., SHAH, Z., SAJJAD, A., HASSAN, M., ALI, H., ANSARI, M., RAZVI, S., & QASIM, A. (2024). MULTIFACETED INTENSIVE BLOOD PRESSURE CONTROL MODEL IN ELDERLY PATIENTS WITH HYPERTENSION. Biological and Clinical Sciences Research Journal, 2024(1), 1269. https://doi.org/10.54112/bcsrj.v2024i1.1269

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