Document Detail


Blood pressure behavior in the nursing home: implications for diagnosis and treatment of hypertension.
MedLine Citation:
PMID:  10078889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine patterns of elevated blood pressure (BP) behavior, their clinical correlates, and the relationship to diagnosis and management of hypertension. DESIGN: A cross-sectional, prevalence survey. SETTING: Forty-five nursing homes owned or managed by a large national chain. PARTICIPANTS: A total of 857 older residents (mean age = 84 years). MEASUREMENTS: Supine and standing (1 and 3 minutes) BP and heart rate, taken four times in one day (before and after breakfast, and before and after lunch) by trained nurses using a random zero sphygmomanometer; medication profile; active medical diagnoses; functional status; sociodemographics. RESULTS: The prevalence of a single, elevated, supine systolic pressure (> or = 160 mm Hg) was 14.3%, and of two to four elevated measures was 14.9%. The pre-breakfast reading was consistently the highest, and mean systolic pressures decreased after breakfast. Compared with those not treated, older residents taking antihypertensive medications had higher systolic pressures at all times and showed the same pattern of decline after breakfast. Isolated diastolic hypertension was uncommon (0.9%). Cardiovascular disease, orthostatic hypotension, diabetes, and use of angiotensin converting enzyme inhibitors or calcium channel blockers were more prevalent among older residents who had elevated pressures on multiple occasions (P < .03). Successful antihypertensive treatment was associated with a lower prevalence of orthostatic hypotension. Diuretic use was more likely to be associated with blood pressure control. CONCLUSION: The diagnosis of hypertension in frail older people would benefit from multiple, within-day measures, including postural BP, taken before and after meals. Diuretic use alone, or in conjunction with ACE inhibitors or calcium channel blockers, was more likely to be associated with normalized blood pressures.
Authors:
A Auseon; W L Ooi; M Hossain; L A Lipsitz
Related Documents :
18490229 - Efficacy of a very-low-dose combination of perindopril and indapamide--preterax compare...
9989539 - Prognosis of diastolic and systolic orthostatic hypotension in older persons.
16315369 - Predictors of hypertension and changes of blood pressure in hiv-infected patients.
18250979 - A comparison of nicardipine and labetalol for acute hypertension management following s...
18855259 - Blood pressure-lowering efficacy of amiloride versus enalapril as add-on drugs in patie...
21054769 - 24-hour ambulatory blood pressure response to combination valsartan/hydrochlorothiazide...
12857509 - Use of a self-designed bladder controller for restoring bladder function in paraplegic ...
3392669 - Filtration coefficient and osmotic reflection coefficient to albumin in rabbit submandi...
17855479 - P2 purinoceptor-mediated cardioprotection in ischemic-reperfused mouse heart.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  47     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-03-25     Completed Date:  1999-03-25     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  285-90     Citation Subset:  IM    
Affiliation:
Research & Training Institute, Hebrew Rehabilitation Center for Aged, Boston, Massachusetts, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antihypertensive Agents / therapeutic use
Blood Pressure Determination / methods*
Cross-Sectional Studies
Diuretics / therapeutic use
Drug Therapy, Combination
Female
Frail Elderly*
Heart Rate
Humans
Hypertension* / diagnosis,  drug therapy,  physiopathology
Male
Nursing Homes
Prevalence
Supine Position
Time Factors
Grant Support
ID/Acronym/Agency:
AG04390/AG/NIA NIH HHS; AG09538/AG/NIA NIH HHS; AG11023/AG/NIA NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Diuretics
Comments/Corrections
Comment In:
J Am Geriatr Soc. 1999 Mar;47(3):373-4   [PMID:  10078905 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The effects of aerobic exercise and T'ai Chi on blood pressure in older people: results of a randomi...
Next Document:  Management and outcome of acute myocardial infarction in older patients in the thrombolytic era.