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Hypertension in the Elderly

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      References

        • Chobanian A.V.
        • Bakris G.L.
        • Black H.R.
        • et al.
        The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report.
        JAMA. 2003; 289: 2560-2572
        • Lakatta E.G.
        Mechanisms of hypertension in the elderly.
        J Am Geriatr Soc. 1989; 37: 780-790
        • Gribbin B.
        • Pickering G.T.
        • Sleight P.
        • et al.
        Effect of age and high blood pressure on baroreflex sensitivity in man.
        Circ Res. 1971; 29: 424-431
        • Aronow W.S.
        Dizziness and syncope.
        in: Hazzard W.R. Blass J.P. Ettinger Jr., W.H. Principles of geriatric medicine and gerontology. 4th edition. McGraw-Hill, Incorporated, New York1998: 1519-1534
        • Joseph J.
        • Koka M.
        • Aronow W.S.
        Prevalence of moderate and severe renal insufficiency in older persons with hypertension, diabetes mellitus, coronary artery disease, peripheral arterial disease, ischemic stroke, or congestive heart failure in an academic nursing home.
        J Am Med Dir Assoc. 2008; 9: 257-259
        • Chiong J.R.
        • Aronow W.S.
        • Khan I.A.
        • et al.
        Secondary hypertension: current diagnosis and treatment.
        Int J Cardiol. 2008; 124: 6-21
        • Lloyd-Jones D.
        • Adams R.
        • Carnethon M.
        • et al.
        Heart disease and stroke statistics—2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.
        Circulation. 2009; 119: e21-181
        • Vasan R.S.
        • Larson M.G.
        • Leip E.P.
        • et al.
        Impact of high–normal blood pressure on the risk of cardiovascular disease.
        N Engl J Med. 2001; 345: 1291-1297
        • Mendelson G.
        • Ness J.
        • Aronow W.S.
        Drug treatment of hypertension in older persons in an academic hospital-based geriatrics practice.
        J Am Geriatr Soc. 1999; 47: 597-599
        • Aronow W.S.
        • Ahn C.
        • Gutstein H.
        Prevalence and incidence of cardiovascular disease in 1160 older men and 2464 older women in a long-term health care facility.
        J Gerontol A Biol Sci Med Sci. 2002; 57A: M45-M46
        • Koka M.
        • Joseph J.
        • Aronow W.S.
        Adequacy of control of hypertension in an academic nursing home.
        J Am Med Dir Assoc. 2007; 8: 538-540
        • Joseph J.
        • Koka M.
        • Aronow W.S.
        Prevalence of a hemoglobin A1c <7.0%, of a blood pressure <130/80 mm Hg, and of a serum low-density lipoprotein cholesterol <100 mg/dL in older patients with diabetes mellitus in an academic nursing home.
        J Am Med Dir Assoc. 2008; 9: 51-54
      1. National High Blood Pressure Education Program Working Group. National High Blood Pressure Education Program working group report on hypertension in the elderly.
        Hypertens. 1994; 23: 275-285
        • Madhavan S.
        • Ooi W.L.
        • Cohen H.
        • et al.
        Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction.
        Hypertens. 1994; 23: 395-401
        • Rigaud A.S.
        • Forette B.
        Hypertension in older adults.
        J Gerontol A Biol Sci Med Sci. 2001; 56: M217-M225
        • Fried L.P.
        • Kronmal R.A.
        • Newman A.B.
        • et al.
        Risk factors for 5-year mortality in older adults. The Cardiovascular Health Study.
        JAMA. 1998; 279: 585-592
        • Molander L.
        • Lovheim H.
        • Norman T.
        • et al.
        Lower systolic blood pressure is associated with greater mortality in people aged 85 and older.
        J Am Geriatr Soc. 2008; 56: 1853-1859
        • Aronow W.S.
        • Ahn C.
        • Kronzon I.
        • et al.
        Congestive heart failure, coronary events, and atherothrombotic brain infarction in elderly blacks and whites with systemic hypertension and with and without echocardiographic and electrocardiographic evidence of left ventricular hypertrophy.
        Am J Cardiol. 1991; 67: 295-299
        • Aronow W.S.
        • Ahn C.
        Risk factors for new coronary events in a large cohort of very elderly patients with and without coronary artery disease.
        Am J Cardiol. 1996; 77: 864-866
        • Vokonas P.S.
        • Kannel W.B.
        Epidemiology of coronary heart disease in the elderly.
        in: Aronow W.S. Fleg J.L. Rich M.W. Cardiovascular disease in the elderly. 4th edition. Informa Healthcare, New York2008: 215-241
        • Franklin S.S.
        • Larson M.G.
        • Khan S.A.
        • et al.
        Does the relation of blood pressure to coronary heart disease risk change with aging? The Framingham Heart Study.
        Circulation. 2001; 103: 1245-1249
        • Psaty B.M.
        • Furberg C.D.
        • Kuller L.H.
        • et al.
        Association between blood pressure level and the risk of myocardial infarction, stroke, and total mortality: the Cardiovascular Health Study.
        Arch Intern Med. 2001; 161: 1183-1192
        • Aronow W.S.
        • Ahn C.
        • Gutstein H.
        Risk factors for new atherothrombotic brain infarction in 664 older men and 1488 older women.
        Am J Cardiol. 1996; 77: 1381-1383
        • Aronow W.S.
        • Frishman W.H.
        Treatment of hypertension and prevention of ischemic stroke.
        Curr Cardiol Rep. 2004; 6: 124-129
        • Wolf P.A.
        Cerebrovascular disease in the elderly.
        in: Tresch D.D. Aronow W.S. Cardiovascular disease in the elderly patient. Marcel Dekker, Incorporated, New York1994: 125-147
        • Aronow W.S.
        • Ahn C.
        • Kronzon I.
        Comparison of incidences of congestive heart failure in older African Americans, Hispanics, and whites.
        Am J Cardiol. 1999; 84: 611-612
        • Levy D.
        • Larson M.G.
        • Vasan R.S.
        • et al.
        The progression from hypertension to congestive heart failure.
        JAMA. 1996; 275: 1557-1562
        • Stokes III, J.
        • Kannel W.B.
        • Wolf P.A.
        • et al.
        The relative importance of selected risk factors for various manifestations of cardiovascular disease among men and women from 35 to 64 years old: 30 years of follow-up in the Framingham Study.
        Circulation. 1987; 75: V65-V73
        • Aronow W.S.
        • Sales F.F.
        • Etienne F.
        • et al.
        Prevalence of peripheral arterial disease and its correlation with risk factors for peripheral arterial disease in elderly patients in a long-term health care facility.
        Am J Cardiol. 1988; 62: 644-646
        • Ness J.
        • Aronow W.S.
        • Ahn C.
        Risk factors for peripheral arterial disease in an academic hospital-based geriatrics practice.
        J Am Geriatr Soc. 2000; 48: 312-314
        • Ness J.
        • Aronow W.S.
        • Newkirk E.
        • et al.
        Prevalence of symptomatic peripheral arterial disease, modifiable risk factors, and appropriate use of drugs in the treatment of peripheral arterial disease in older persons seen in a university general medicine clinic.
        J Gerontol A Biol Sci Med Sci. 2005; 60: M255-M257
        • Aronow W.S.
        • Ahmed M.I.
        • Ekundayo O.J.
        • et al.
        A propensity-matched study of the association of peripheral arterial disease with cardiovascular outcomes in community-dwelling older adults.
        Am J Cardiol. 2009; 103: 130-135
        • Hyman D.J.
        • Pavlik V.N.
        Characteristics of patients with uncontrolled hypertension in the United States.
        N Engl J Med. 2001; 345: 479-486
        • Gandelman G.
        • Aronow W.S.
        • Varma R.
        Prevalence of adequate blood pressure control in self-pay or Medicare patients versus Medicaid or private insurance patients with systemic hypertension followed in a university cardiology or general medicine clinic.
        Am J Cardiol. 2004; 94: 815-816
      2. Report by the Management Committee. The Australian therapeutic trial in mild hypertension.
        Lancet. 1980; 1: 1261-1267
      3. Medical Research Council Working Party. MRC trial of mild hypertension: principal results.
        Br Med J. 1985; 291: 97-104
      4. MRC Working Party. Medical Research Council Trial of treatment of hypertension in older adults: principal results.
        Br Med J. 1992; 304: 405-412
        • Amery A.
        • Birkenhager W.
        • Brixko P.
        • et al.
        Morbidity and mortality results from the European Working Party on High Blood Pressure in the Elderly Trial.
        Lancet. 1985; 1: 1349-1354
        • Coope J.
        • Warrender T.S.
        Randomised trial of the treatment of hypertension in elderly patients in primary care.
        Br Med J. 1986; 293: 1145-1151
        • Dahlof B.
        • Lindholm L.H.
        • Hansson L.
        • et al.
        Morbidity and mortality in the Swedish Trial in Old Patients With Hypertension (STOP Hypertension).
        Lancet. 1991; 338: 1281-1285
      5. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP).
        JAMA. 1991; 265: 3255-3264
        • Kostis J.B.
        • Davis B.R.
        • Cutler J.
        • et al.
        Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension.
        JAMA. 1997; 278: 212-216
        • Perry Jr., H.M.
        • Davis B.R.
        • Price T.R.
        • et al.
        Effect of treating isolated systolic hypertension on the risk of developing various types and subtypes of stroke. The Systolic Hypertension in the Elderly Program (SHEP).
        JAMA. 2000; 284: 465-471
        • Staessen J.A.
        • Fagard R.
        • Thijs L.
        • et al.
        Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension.
        Lancet. 1997; 350: 757-764
        • Wang J.-G.
        • Staessen J.A.
        • Gong L.
        • et al.
        Chinese trial on isolated systolic hypertension in the elderly.
        Arch Intern Med. 2000; 160: 211-220
        • Beckett N.S.
        • Peters R.
        • Fletcher A.E.
        • et al.
        Treatment of hypertension in patients 80 years of age or older.
        N Engl J Med. 2008; 358: 1887-1898
        • Aronow W.S.
        • Frishman W.H.
        Effect of antihypertensive drug treatment on cognitive function.
        Clin Geriatr. 2006; 14: 25-28
        • Progress Collaborative Group
        Randomised trial of a perindopril-based blood pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack.
        Lancet. 2001; 358: 1033-1041
        • Forette F.
        • Seux M.L.
        • Staessen J.A.
        • et al.
        The prevention of dementia with antihypertensive treatment. New evidence from the Systolic Hypertension in Europe (Syst-Eur) study.
        Arch Intern Med. 2002; 162: 2046-2052
        • Murray M.D.
        • Lane K.A.
        • Gao S.
        • et al.
        Preservation of cognitive function with antihypertensive medications. A longitudinal analysis of a community-based sample of African Americans.
        Arch Intern Med. 2002; 162: 2090-2096
        • Veld B.A.
        • Ruitenberg A.
        • Holman A.
        • et al.
        Antihypertensive drugs and incidence of dementia: the Rotterdam Study.
        Neurobiol Aging. 2001; 22: 407-412
        • Saxby B.K.
        • Harrington F.
        • Wesnes K.A.
        • et al.
        Candesartan and cognitive decline in older patients with hypertension: a substudy of the SCOPE trial.
        Neurology. 2008; 70: 1858-1866
        • Peters R.
        • Beckett N.
        • Forette F.
        • et al.
        Incident dementia and blood pressure lowering in the Hypertension in the Very elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo-controlled trial.
        Lancet Neurol. 2008; 7: 683-689
        • Aronow W.S.
        What is the appropriate treatment of hypertension in elders? [editorial].
        J Gerontol A Biol Sci Med Sci. 2002; 57: M483-M486
        • Goodwin J.S.
        Embracing complexity: a consideration of hypertension in the very old.
        J Gerontol A Biol Sci Med Sci. 2003; 58: M653-M658
        • Aronow W.S.
        Older age should not be a barrier to the treatment of hypertension.
        Nat Clin Pract Cardiovasc Med. 2008; 5: 514-515
        • Mendelson G.
        • Nassimiha D.
        • Aronow W.S.
        Simultaneous measurements of blood pressures in right and left brachial arteries.
        Cardiol Rev. 2004; 12: 276-278
        • Palmer B.F.
        Renal dysfunction complicating the treatment of hypertension.
        N Engl J Med. 2002; 347: 1256-1261
        • Hricick D.E.
        • Browning P.J.
        • Kopelman R.
        • et al.
        Captopril-induced functional renal insufficiency in patients with bilateral renal artery stenosis or renal artery stenosis in a solitary kidney.
        N Engl J Med. 1983; 308: 373-376
        • Toto R.D.
        • Mitchell H.C.
        • Lee H.C.
        • et al.
        Reversible renal insufficiency due to angiotensin-converting enzyme inhibitors in hypertensive nephrosclerosis.
        Ann Intern Med. 1991; 115: 513-519
        • Rosendorff C.
        • Black H.R.
        • Cannon C.P.
        • et al.
        Treatment of hypertension in the prevention and management of ischemic heart disease. A scientific statement from the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention.
        Circulation. 2007; 115: 2761-2788
        • Pahor M.
        • Guralnik J.M.
        • Corti C.
        • et al.
        Long-term survival and use of antihypertensive medications in older persons.
        J Am Geriatr Soc. 1995; 43: 1191-1197
        • Aronow W.S.
        Verapamil as an antiarrhythmic agent.
        in: Gould L.A. Drug treatment of cardiac arrhythmias. Futura Publishing Company, Incorporated, Mount Kisco (NY)1983: 325-341
      6. The Multicenter Diltiazem Postinfarction Trial Research Group. The effect of diltiazem on mortality and reinfarction after myocardial infarction.
        N Engl J Med. 1988; 319: 385-392
        • Goldstein R.E.
        • Boccuzzi S.J.
        • Cruess D.
        • et al.
        Diltiazem increases late-onset congestive heart failure in postinfarction patients with early reduction in ejection fraction.
        Circulation. 1991; 83: 52-60
        • Aronow W.S.
        • Ahn C.
        Incidence of new coronary events in older persons with prior myocardial infarction and systemic hypertension treated with beta blockers, angiotensin-converting enzyme inhibitors, diuretics, calcium antagonists, and alpha blockers.
        Am J Cardiol. 2002; 89: 1207-1209
        • Elkayam U.
        • Amin J.
        • Mehra A.
        • et al.
        A prospective, randomized, double-blind, crossover study to compare the efficacy and safety of chronic nifedipine therapy with that of isosorbide dinitrate and their combination in the treatment of chronic congestive heart failure.
        Circulation. 1990; 82: 1954-1961
        • ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group
        Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).
        JAMA. 2000; 283: 1967-1975
        • Frishman W.H.
        • Aronow W.S.
        • Cheng-Lai A.
        Cardiovascular drug therapy in the elderly.
        in: Aronow W.S. Fleg J.L. Rich M.W. Cardiovascular disease in the elderly. fourth edition. Informa Healthcare, New York2008: 99-135
        • Cameron H.A.
        • Ramsay L.E.
        The lupus syndrome induced by hydralazine: a common complication with low-dose treatment.
        Br Med J (Clin Res Ed). 1984; 289: 410-412
        • Krehlik J.M.
        • Hindson D.A.
        • Crowley Jr., J.J.
        • et al.
        Minoxidil-associated pericarditis and fatal cardiac tamponade.
        West J Med. 1986; 143: 527-529
        • Ryan T.J.
        • Antman E.M.
        • Brooks N.H.
        • et al.
        1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction: executive summary and recommendations. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction).
        Circulation. 1999; 100: 1016-1030
        • Aronow W.S.
        • Ahn C.
        Effect of beta blockers on incidence of new coronary events in older persons with prior myocardial infarction and diabetes mellitus.
        Am J Cardiol. 2001; 87: 780-781
        • Aronow W.S.
        • Ahn C.
        Effect of beta blockers on incidence of new coronary events in older persons with prior myocardial infarction and symptomatic peripheral arterial disease.
        Am J Cardiol. 2001; 87: 1284-1286
      7. The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an angiotensin-converting enzyme inhibitor, ramipril on cardiovascular events in high-risk patients.
        N Engl J Med. 2000; 342: 145-153
        • Aronow W.S.
        • Ahn C.
        • Kronzon I.
        Effect of beta blockers alone, of angiotensin-converting enzyme inhibitors alone, and of beta blockers plus angiotensin-converting enzyme inhibitors on new coronary events and on congestive heart failure in older persons with healed myocardial infarcts and asymptomatic left ventricular systolic dysfunction.
        Am J Cardiol. 2001; 88: 1298-1300
        • Kennedy H.L.
        • Brooks M.M.
        • Barker A.H.
        • et al.
        Beta-blocker therapy in the Cardiac Arrhythmia Suppression Trial.
        Am J Cardiol. 1994; 74: 674-680
        • Aronow W.S.
        • Ahn C.
        • Mercando A.D.
        • et al.
        Effect of propranolol versus no antiarrhythmic drug on sudden cardiac death, total cardiac death, and total death in patients ≥62 years of age with heart disease, complex ventricular arrhythmias, and left ventricular ejection fraction ≥40%.
        Am J Cardiol. 1994; 74: 267-270
      8. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF).
        Lancet. 1999; 353 (MERIT-HF Study Group.): 2001-2007
        • Flather M.D.
        • Shibata M.C.
        • Coats A.J.S.
        • et al.
        Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS).
        Eur Heart J. 2005; 26: 215-225
        • Aronow W.S.
        • Ahn C.
        • Kronzon I.
        Effect of propranolol versus no propranolol on total mortality plus nonfatal myocardial infarction in older patients with prior myocardial infarction, congestive heart failure, and left ventricular ejection fraction ≥40% treated with diuretics plus angiotensin-converting-enzyme inhibitors.
        Am J Cardiol. 1997; 80: 207-209
        • Aronow W.S.
        • Frishman W.H.
        Angina in the elderly.
        in: Aronow W.S. Fleg J.L. Rich M.W. Cardiovascular disease in the elderly. fourth edition. Informa Healthcare, New York2008: 269-292
        • Aronow W.S.
        • Ahn C.
        • Mercando A.D.
        • et al.
        Decrease of mortality by propranolol in patients with heart disease and complex ventricular arrhythmias is more an antiischemic than an antiarrhythmic effect.
        Am J Cardiol. 1994; 74: 613-615
        • Aronow W.S.
        Treatment of atrial fibrillation. Part 1.
        Cardiol Rev. 2008; 16: 181-188
        • Aronow W.S.
        Treatment of atrial fibrillation and atrial flutter. Part 2.
        Cardiol Rev. 2008; 16: 230-239
        • Aronow W.S.
        The heart and thyroid disease.
        Clin Geriatr Med. 1995; 11: 219-229
        • Hunt S.A.
        • Baker D.W.
        • Chin M.H.
        • et al.
        ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1995 Guidelines for the Evaluation and Management of Heart Failure). Developed in collaboration with the International Society for Heart and Lung Transplantation. Endorsed by the Heart Failure Society of America.
        J Am Coll Cardiol. 2001; 38: 2101-2113
        • Agodoa L.Y.
        • Appel L.
        • Bakris G.L.
        • et al.
        Effect of ramipril versus amlodipine on renal outcomes in hypertensive nephrosclerosis. A randomized controlled trial.
        JAMA. 2001; 285: 2719-2728
        • Brenner B.M.
        • Cooper M.E.
        • de Zeeuw D.
        • et al.
        Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy.
        N Engl J Med. 2001; 345: 861-869
        • Smith Jr., S.C.
        • Allen J.
        • Blair S.N.
        • et al.
        ACC/AHA guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute.
        Circulation. 2006; 113: 2363-2372
        • Grundy S.M.
        • Cleeman J.I.
        • Merz C.N.B.
        • et al.
        Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines.
        Circulation. 2004; 110: 227-239
        • American Diabetes Association
        Standards of medical care for patients with diabetes mellitus.
        Diabetes Care. 2003; 26: 533-550
        • Stratton I.M.
        • Adler A.I.
        • Neil H.A.
        • et al.
        Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study.
        Br Med J. 2000; 321: 405-412
        • Ravipati G.
        • Aronow W.S.
        • Ahn C.
        • et al.
        Association of hemoglobin A1c level with the severity of coronary artery disease in patients with diabetes mellitus.
        Am J Cardiol. 2006; 97: 968-969
        • Aronow W.S.
        • Ahn C.
        • Weiss M.B.
        • et al.
        Relation of hemoglobin A1c levels to severity of peripheral arterial disease in patients with diabetes mellitus.
        Am J Cardiol. 2007; 99: 1468-1469