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Целевые уровни артериального давления у пациентов с артериальной гипертензией и синдромом старческой астении
Целевые уровни артериального давления у пациентов с артериальной гипертензией и синдромом старческой астении
Остроумова О.Д., Черняева М.С., Морозов А.П. Целевые уровни артериального давления у пациентов с артериальной гипертензией и синдромом старческой астении. Системные гипертензии. 2019; 16 (4): 52–60. DOI: 10.26442/2075082X.2019.4.190577
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Аннотация
Артериальная гипертензия (АГ) является важной проблемой общественного здравоохранения во всем мире. Высокая распространенность АГ частично может объясняться увеличением артериального давления (АД) с возрастом и быстрым ростом пожилого населения (возраст старше 65 лет). Несмотря на влияние возраста на АД, доказательства относительно его целевых значений при контроле у больных старших возрастных групп с АГ ограниченны, особенно при наличии у них синдрома старческой астении (ССА). Имеются данные ряда исследований, в которых выявлена взаимосвязь между более низкими уровнями АД и смертностью от всех причин у пациентов с АГ в старших возрастных группах. В клинической практике решения относительно целевых показателей АД особенно сложны у пожилых людей с ССА, часто не соответствуют критериям включения в рандомизированные контролируемые исследования, и для этой группы пожилого населения клинические рекомендации ведущих сообществ не дают конкретного ответа о целевом уровне АД. Доказательная база относительно целевых значений АД при лечении АГ у пациентов старших возрастных групп с ССА, представленная в настоящем обзоре, немногочисленна, однако ее анализ позволяет говорить о преимуществах более высоких цифр АД с максимальными значениями систолического АД 165 мм рт. ст. и диастолического АД 90 мм рт. ст., тогда как более низкие уровни АД могут оказаться небезопасными в плане увеличения риска развития неблагоприятных сердечно-сосудистых событий и смертности как от сердечно-сосудистых причин, так и от всех причин. Полиморбидность в сочетании с полипрагмазией и повышенным риском нежелательных явлений требует ориентированного на пациента индивидуального подхода к назначению антигипертензивной терапии. Для окончательного принятия решения по поводу тактики ведения пациентов с АГ и ССА необходимы крупные специально спланированные рандомизированные клинические исследования.
Ключевые слова: артериальная гипертензия, целевое артериальное давление, старческий возраст, старческая астения.
Ключевые слова: артериальная гипертензия, целевое артериальное давление, старческий возраст, старческая астения.
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Полный текст
Список литературы
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17. Zanchetti A, Grassi G, Mancia G. When should antihypertensive drug treatment be initiated and to what levels should systolic blood pressure be lowered? A critical reappraisal. J Hypertens 2009; 27: 923–34. DOI: 10.1097/HJH.0b013e32832aa6b5
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20. Chernyaeva M.S., Ostroumova O.D. Target Levels of Systolic and Diastolic Blood Pressure in Very Old Patients with Arterial Hypertension without Frailty. Lechebnoe delo. 2019 1: 44–58. DOI: 10.24411/2071-5315-2019-12089 (in Russian).
21. Clinical guidelines. Senile asthenia. Russian Association of Gerontologists and Geriatrics (2018). http: //aggrb.ru/images/Doc/Asteniya_recomend.pdf (in Russian).
22. Clegg A, Young J, Iliffe S et al. Frailty in elderly people. Lancet 2013; 381 (9868): 752–62. DOI: 10.1016/S0140-6736 (12)62167-9
23. Collard RM, Boter H, Schoevers RA et al. Prevalence of frailty in community dwelling older persons: a systematic review. J Am Geriatr Soc 2012; 60 (8): 1487–92. DOI: 10.1111/j.1532-5415.2012.04054.x
24. Kojima G. Prevalence of frailty in nursing homes: A systematic review and metaanalysis. J Am Med Dir Assoc 2015; 16 (11): 940–95. DOI: 10.1016/j.jamda.2015.06.025
25. Buta BJ, Walston JD, Godino JG et al. Frailty assessment instruments: systematic characterization of the uses and contexts of highly-cited instruments. Ageing Res Rev 2016; 26: 53–61. DOI: 10.1016/j.arr.2015.12.003
26. Fried LP, Borhani NO, Enright P et al. The Cardiovascular Health Study: design and rationale. Ann Epidemiol 1991; 1: 263–76.
27. Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol Med Sci 2001; 56 (3): 146–56. DOI: 10.1093/gerona/56.3.m146
28. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J 2001; 1: 323–36. DOI: 10.1100/tsw.2001.58
29. Guralnik JM, Simonsick EM, Ferrucci L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994; 49 (2): M85–94.
30. Guralnik JM, Ferrucci L, Simonsick EM et al. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995; 332 (9): 556–61. DOI: 10.1056/NEJM199503023320902
31. Diehr P, Williamson J, Burke GL, Psaty BM. The aging and dying processes and the health of older adults. J Clin Epidemiol 2002; 55: 269–78.
32. Van Bemmel T, Holman ER, Gussekloo J et al. Low blood pressure in the very old, a consequence of imminent heart failure: the Leiden 85-plus Study. J Hum Hypertens 2009; 23: 27–32. DOI: 10.1038/jhh.2008.79
33. Muller M, Smulders YM, de Leeuw PW, Stehouwer CD. Treatment of hypertension in the oldest old: a critical role for frailty? Hypertension 2014; 63: 433–41. DOI: 10.1161/HYPERTENSIONAHA.113.00911
34. Benetos A, Rossignol P, Cherubini A et al. Polypharmacy in the aging patient: management of hypertension in octogenarians. JAMA 2015; 314 (2): 170–80. DOI: 10.1001/jama.2015.7517
35. Sabayan B, Oleksik AM, Maier AB et al. High blood pressure and resilience to physical and cognitive decline in the oldest old: the Leiden 85-plus study. J Am Geriatr Soc 2012; 60 (11): 2014–19. DOI: 10.1111/j.1532-5415.2012.04203.x
36. Benetos A, Gautier S, Labat C et al. Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjects: the PARTAGE (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population) study. J Am Coll Cardiol 2012; 60: 1503–11. DOI: 10.1016/j.jacc.2012.04.055
37. Benetos A, Labat C, Rossignol P 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 (6): 989–95. DOI: 10.1001/jamainternmed.2014.8012
38. Odden MC, Covinsky KE, Neuhaus JM et al. The association of blood pressure and mortality differs by selfreported walking speed in older Latinos. J Gerontol A Biol Sci Med Sci 2012; 67: 977–83. DOI: 10.1093/gerona/glr245
39. Ogliari G, Westendorp RG, Muller M et al. Blood pressure and 10-year mortality risk in the Milan Geriatrics 75+ Cohort Study: role of functional and cognitive status. Age Ageing 2015; 44: 932–7. DOI: 10.1093/ageing/ afv141
40. Mossello E, Pieraccioli M, Nesti et al. N Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs. JAMA Intern Med 2015; 175: 578–85. DOI: 10.1001/
jamainternmed.2014.8164
41. Van Hateren KJ, Hendriks SH, Groenier KH et al. Frailty and the relationship between blood pressure and mortality in elderly patients with type 2 diabetes (Zwolle Outpatient Diabetes project Integrating Available Care-34). J Hypertens 2015; 33 (6): 1162–6. DOI: 10.1097/HJH.0000000000000555
42. Sirola J, Pitkala KH, Tilvis RS et al. Definition of frailty in older men according to questionnaire data (RAND-36/SF36): The Helsinki Businessmen Study. J Nutr Health Aging 2011; 15: 783–7.
43. Chang YW, Chen WL, Lin FG et al. Frailty and its impact on health-related quality of life: a cross-sectional study on elder community-dwelling preventive health service users. PLoS One 2012; 7: e038079. DOI: 10.1371/journal.pone.0038079
44. Mansur HN, Colugnati FA, Grincenkov FR, Bastos MG. Frailty and quality of life: a cross-sectional study of Brazilian patients with predialysis chronic kidney disease. Health Qual Life Outcomes 2014; 12: 27. DOI: 10.1186/1477-7525-12-27
45. Odden MC, Peralta CA, Haan MN, Covinsky KE. Rethinking the association of high blood pressure with mortality in elderly adults: the impact of frailty. Arch Intern Med 2012; 172 (15): 1162–8. DOI: 10.1001/archinternmed.2012.2555
46. Fratiglioni L, Viitanen M, Backman L et al. Occurrence of dementia in advanced age: the study design of the Kungsholmen Project. Neuroepidemiology 1992; 11 (Suppl. 1): 29–36. DOI: 10.1159/000110958
47. Guo Z, Viitanen M, Winblad B. Low blood pressure and five-year mortality in a Stockholm cohort of the very old: possible confounding by cognitive impairment and other factors. Am J Public Health 1997; 87 (4): 623–8. DOI: 10.2105/ajph.87.4.623
48. Post Hospers G, Smulders YM, Maier AB et al. Relation between blood pressure and mortality risk in an older population: role of chronological and biological age. J Intern Med 2015; 277 (4): 488–97. DOI: 10.1111/joim.12284
49. Satish S, Zhang DD, Goodwin JS. Clinical significance of falling blood pressure among older adults. J Clin Epidemiol 2001; 54 (9): 961–7.
50. Anker D, Santos-Eggimann B, Santschi V et al. Screening and treatment of hypertension in older adults: less is more? Public Health Rev 2018; 3 (39): 26. DOI: 10.1186/s40985-018-0101-z. eCollection 2018
51. Ravindrarajah R, Hazra NC, Hamada S et al. Systolic blood pressure trajectory, frailty, and all-cause mortality > 80 years of age: cohort study using electronic health records. Circulation 2017; 135 (24): 2357–68. DOI: 10.1161/CIRCULATIONAHA.116.026687
2. http://www.who.int/ health_financing/topics/resource-tracking/ghed-update/en/
3. Foy AJ, Mandrola JM. Heavy Heart: The economic burden of heart disease in the United States Now and in the future. Prim Care 2018; 45 (1): 17–24. DOI: 10.1016/j.pop.2017.11.002
4. Шальнова С.А., Баланова Ю.А., Константинов В.В. и др. Артериальная гипертония: распространенность, осведомленность, прием антигипертензивных препаратов и эффективность лечения среди населения Российской Федерации. Рос. кардиологич. журн. 2006; 4: 45–50.
[Shal'nova S.A., Balanova Iu.A., Konstantinov V.V. et al. Arterial hypertension: prevalence, awareness, taking antihypertensive drugs and treatment effectiveness among the population of the Russian Federation. Ros. kardiologich. zhurn. 2006; 4: 45–50 (in Russian).]
5. Chow CK, Teo KK, Rangarajan S et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA 2013; 310: 959–68. DOI: 10.1001/jama.2013.184182
6. Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России. Информированность, лечение, контроль. Профилактика заболеваний и укрепление здоровья. 2001; 2: 3–7.
[Shal'nova S.A., Deev A.D., Vikhireva O.V. et al. The prevalence of arterial hypertension in Russia. Awareness, treatment, control. Profilaktika zabolevanii i ukreplenie zdorov'ia. 2001; 2: 3–7 (in Russian).]
7. Трубин В., Николаева Н., Палеева М., Гавдифаттова С. Пожилое население России: проблемы и перспективы. Соц. бюллетень. 2016; 5: 3–45.
[Trubin V., Nikolaeva N., Paleeva M., Gavdifattova S. The elderly population of Russia: problems and prospects. Sots. biulleten'. 2016; 5: 3–45. (Russian).]
8. Forouzanfar MH, Liu P, Roth GA et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990–2015. JAMA 2017; 317: 165–82. DOI: 10.1001/jama.2016.19043
9. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 39 (33): 3021–104. DOI: 10.1093/eurheartj/ehy339
10. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358 (18): 1887–98. DOI: 10.1056/NEJMoa0801369
11. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meat-analysis of 147 randomized trials in the context of expectations from prospective epidemiological studies. Br Med J 2009; 338: b1665. DOI: 10.1136/bmj.b1665
12. Zanchetti A, Thomopoulos C, Parati G. Randomized controlled trials of blood pressure lowering in hypertension: a critical reappraisal. Circ Res 2015; 116: 1058–107. DOI: 10.1161/CIRCRESAHA.
116.303641
13. Grassi G, Quarti-Trevano F, Casati A, Dell’Oro R. Threshold and target for blood pressure lowering in the elderly. Curr Atheroscler Rep 2016; 18 (12): 70. DOI: 10.1007/s11883-016-0627-9
14. SPRINT Research Group, Wright JT Jr, Williamson JD et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373 (22): 2103–16. DOI: 10.1056/NEJMoa1511939
15. Ettehad D, Emdin CA, Kiran A et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016; 387: 957–67. DOI: 10.1016/S0140-6736(15)01225-8
16. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34: 2159–219. DOI: 10.1097/01.hjh.0000431740.32696.cc
17. Zanchetti A, Grassi G, Mancia G. When should antihypertensive drug treatment be initiated and to what levels should systolic blood pressure be lowered? A critical reappraisal. J Hypertens 2009; 27: 923–34. DOI: 10.1097/HJH.0b013e32832aa6b5
18. Benetos A, Bulpitt CJ, Petrovic M et al. An expert opinion from the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the management of hypertension in very old, frail subjects. Hypertension 2016; 67: 820–5. DOI: 10.1161/HYPERTENSIONAHA.115.07020
19. Чазова И.Е., Жернакова Ю.В. от имени экспертов. Клинические рекомендации. Диагностика и лечение артериальной гипертонии. Системные гипертензии. 2019; 16 (1): 6–31. DOI: 10.26442/2075082X.2019.1.190179
[Chazova I.E., Zhernakova Ju.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension. 2019; 16 (1): 6–31. DOI: 10.26442/2075082X.2019.1.190179 (in Russian).]
20. Черняева М.С., Остроумова О.Д. Целевые уровни систолического и диастолического артериального давления у пациентов с артериальной гипертонией старческого возраста без синдрома старческой астении. Лечебное дело. 2019; 1: 44–58. DOI: 10.24411/2071-5315-2019-12089
[Chernyaeva M.S., Ostroumova O.D. Target Levels of Systolic and Diastolic Blood Pressure in Very Old Patients with Arterial Hypertension without Frailty. Lechebnoe delo. 2019 1: 44–58. DOI: 10.24411/2071-5315-2019-12089 (in Russian).]
21. Клинические рекомендации Старческая астения. Российская ассоциация геронтологов и гериатров (2018). http://aggrb.ru/images/Doc/Asteniya_recomend.pdf
[Clinical guidelines. Senile asthenia. Russian Association of Gerontologists and Geriatrics (2018). http: //aggrb.ru/images/Doc/Asteniya_recomend.pdf (in Russian).]
22. Clegg A, Young J, Iliffe S et al. Frailty in elderly people. Lancet 2013; 381 (9868): 752–62. DOI: 10.1016/S0140-6736 (12)62167-9
23. Collard RM, Boter H, Schoevers RA et al. Prevalence of frailty in community dwelling older persons: a systematic review. J Am Geriatr Soc 2012; 60 (8): 1487–92. DOI: 10.1111/j.1532-5415.2012.04054.x
24. Kojima G. Prevalence of frailty in nursing homes: A systematic review and metaanalysis. J Am Med Dir Assoc 2015; 16 (11): 940–95. DOI: 10.1016/j.jamda.2015.06.025
25. Buta BJ, Walston JD, Godino JG et al. Frailty assessment instruments: systematic characterization of the uses and contexts of highly-cited instruments. Ageing Res Rev 2016; 26: 53–61. DOI: 10.1016/j.arr.2015.12.003
26. Fried LP, Borhani NO, Enright P et al. The Cardiovascular Health Study: design and rationale. Ann Epidemiol 1991; 1: 263–76.
27. Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol Med Sci 2001; 56 (3): 146–56. DOI: 10.1093/gerona/56.3.m146
28. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J 2001; 1: 323–36. DOI: 10.1100/tsw.2001.58
29. Guralnik JM, Simonsick EM, Ferrucci L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994; 49 (2): M85–94.
30. Guralnik JM, Ferrucci L, Simonsick EM et al. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995; 332 (9): 556–61. DOI: 10.1056/NEJM199503023320902
31. Diehr P, Williamson J, Burke GL, Psaty BM. The aging and dying processes and the health of older adults. J Clin Epidemiol 2002; 55: 269–78.
32. Van Bemmel T, Holman ER, Gussekloo J et al. Low blood pressure in the very old, a consequence of imminent heart failure: the Leiden 85-plus Study. J Hum Hypertens 2009; 23: 27–32. DOI: 10.1038/jhh.2008.79
33. Muller M, Smulders YM, de Leeuw PW, Stehouwer CD. Treatment of hypertension in the oldest old: a critical role for frailty? Hypertension 2014; 63: 433–41. DOI: 10.1161/HYPERTENSIONAHA.113.00911
34. Benetos A, Rossignol P, Cherubini A et al. Polypharmacy in the aging patient: management of hypertension in octogenarians. JAMA 2015; 314 (2): 170–80. DOI: 10.1001/jama.2015.7517
35. Sabayan B, Oleksik AM, Maier AB et al. High blood pressure and resilience to physical and cognitive decline in the oldest old: the Leiden 85-plus study. J Am Geriatr Soc 2012; 60 (11): 2014–19. DOI: 10.1111/j.1532-5415.2012.04203.x
36. Benetos A, Gautier S, Labat C et al. Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjects: the PARTAGE (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population) study. J Am Coll Cardiol 2012; 60: 1503–11. DOI: 10.1016/j.jacc.2012.04.055
37. Benetos A, Labat C, Rossignol P 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 (6): 989–95. DOI: 10.1001/jamainternmed.2014.8012
38. Odden MC, Covinsky KE, Neuhaus JM et al. The association of blood pressure and mortality differs by selfreported walking speed in older Latinos. J Gerontol A Biol Sci Med Sci 2012; 67: 977–83. DOI: 10.1093/gerona/glr245
39. Ogliari G, Westendorp RG, Muller M et al. Blood pressure and 10-year mortality risk in the Milan Geriatrics 75+ Cohort Study: role of functional and cognitive status. Age Ageing 2015; 44: 932–7. DOI: 10.1093/ageing/ afv141
40. Mossello E, Pieraccioli M, Nesti et al. N Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs. JAMA Intern Med 2015; 175: 578–85. DOI: 10.1001/
jamainternmed.2014.8164
41. Van Hateren KJ, Hendriks SH, Groenier KH et al. Frailty and the relationship between blood pressure and mortality in elderly patients with type 2 diabetes (Zwolle Outpatient Diabetes project Integrating Available Care-34). J Hypertens 2015; 33 (6): 1162–6. DOI: 10.1097/HJH.0000000000000555
42. Sirola J, Pitkala KH, Tilvis RS et al. Definition of frailty in older men according to questionnaire data (RAND-36/SF36): The Helsinki Businessmen Study. J Nutr Health Aging 2011; 15: 783–7.
43. Chang YW, Chen WL, Lin FG et al. Frailty and its impact on health-related quality of life: a cross-sectional study on elder community-dwelling preventive health service users. PLoS One 2012; 7: e038079. DOI: 10.1371/journal.pone.0038079
44. Mansur HN, Colugnati FA, Grincenkov FR, Bastos MG. Frailty and quality of life: a cross-sectional study of Brazilian patients with predialysis chronic kidney disease. Health Qual Life Outcomes 2014; 12: 27. DOI: 10.1186/1477-7525-12-27
45. Odden MC, Peralta CA, Haan MN, Covinsky KE. Rethinking the association of high blood pressure with mortality in elderly adults: the impact of frailty. Arch Intern Med 2012; 172 (15): 1162–8. DOI: 10.1001/archinternmed.2012.2555
46. Fratiglioni L, Viitanen M, Backman L et al. Occurrence of dementia in advanced age: the study design of the Kungsholmen Project. Neuroepidemiology 1992; 11 (Suppl. 1): 29–36. DOI: 10.1159/000110958
47. Guo Z, Viitanen M, Winblad B. Low blood pressure and five-year mortality in a Stockholm cohort of the very old: possible confounding by cognitive impairment and other factors. Am J Public Health 1997; 87 (4): 623–8. DOI: 10.2105/ajph.87.4.623
48. Post Hospers G, Smulders YM, Maier AB et al. Relation between blood pressure and mortality risk in an older population: role of chronological and biological age. J Intern Med 2015; 277 (4): 488–97. DOI: 10.1111/joim.12284
49. Satish S, Zhang DD, Goodwin JS. Clinical significance of falling blood pressure among older adults. J Clin Epidemiol 2001; 54 (9): 961–7.
50. Anker D, Santos-Eggimann B, Santschi V et al. Screening and treatment of hypertension in older adults: less is more? Public Health Rev 2018; 3 (39): 26. DOI: 10.1186/s40985-018-0101-z. eCollection 2018
51. Ravindrarajah R, Hazra NC, Hamada S et al. Systolic blood pressure trajectory, frailty, and all-cause mortality > 80 years of age: cohort study using electronic health records. Circulation 2017; 135 (24): 2357–68. DOI: 10.1161/CIRCULATIONAHA.116.026687
________________________________________________
2. http://www.who.int/ health_financing/topics/resource-tracking/ghed-update/en/
3. Foy AJ, Mandrola JM. Heavy Heart: The economic burden of heart disease in the United States Now and in the future. Prim Care 2018; 45 (1): 17–24. DOI: 10.1016/j.pop.2017.11.002
4. Shal'nova S.A., Balanova Iu.A., Konstantinov V.V. et al. Arterial hypertension: prevalence, awareness, taking antihypertensive drugs and treatment effectiveness among the population of the Russian Federation. Ros. kardiologich. zhurn. 2006; 4: 45–50 (in Russian).
5. Chow CK, Teo KK, Rangarajan S et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA 2013; 310: 959–68. DOI: 10.1001/jama.2013.184182
6. Shal'nova S.A., Deev A.D., Vikhireva O.V. et al. The prevalence of arterial hypertension in Russia. Awareness, treatment, control. Profilaktika zabolevanii i ukreplenie zdorov'ia. 2001; 2: 3–7 (in Russian).
7. Trubin V., Nikolaeva N., Paleeva M., Gavdifattova S. The elderly population of Russia: problems and prospects. Sots. biulleten'. 2016; 5: 3–45. (Russian).
8. Forouzanfar MH, Liu P, Roth GA et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990–2015. JAMA 2017; 317: 165–82. DOI: 10.1001/jama.2016.19043
9. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 39 (33): 3021–104. DOI: 10.1093/eurheartj/ehy339
10. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358 (18): 1887–98. DOI: 10.1056/NEJMoa0801369
11. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meat-analysis of 147 randomized trials in the context of expectations from prospective epidemiological studies. Br Med J 2009; 338: b1665. DOI: 10.1136/bmj.b1665
12. Zanchetti A, Thomopoulos C, Parati G. Randomized controlled trials of blood pressure lowering in hypertension: a critical reappraisal. Circ Res 2015; 116: 1058–107. DOI: 10.1161/CIRCRESAHA.
116.303641
13. Grassi G, Quarti-Trevano F, Casati A, Dell’Oro R. Threshold and target for blood pressure lowering in the elderly. Curr Atheroscler Rep 2016; 18 (12): 70. DOI: 10.1007/s11883-016-0627-9
14. SPRINT Research Group, Wright JT Jr, Williamson JD et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373 (22): 2103–16. DOI: 10.1056/NEJMoa1511939
15. Ettehad D, Emdin CA, Kiran A et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016; 387: 957–67. DOI: 10.1016/S0140-6736(15)01225-8
16. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34: 2159–219. DOI: 10.1097/01.hjh.0000431740.32696.cc
17. Zanchetti A, Grassi G, Mancia G. When should antihypertensive drug treatment be initiated and to what levels should systolic blood pressure be lowered? A critical reappraisal. J Hypertens 2009; 27: 923–34. DOI: 10.1097/HJH.0b013e32832aa6b5
18. Benetos A, Bulpitt CJ, Petrovic M et al. An expert opinion from the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the management of hypertension in very old, frail subjects. Hypertension 2016; 67: 820–5. DOI: 10.1161/HYPERTENSIONAHA.115.07020
19. Chazova I.E., Zhernakova Ju.V. on behalf of the experts. Clinical guidelines. Diagnosis and treatment of arterial hypertension. Systemic Hypertension. 2019; 16 (1): 6–31. DOI: 10.26442/2075082X.2019.1.190179 (in Russian).
20. Chernyaeva M.S., Ostroumova O.D. Target Levels of Systolic and Diastolic Blood Pressure in Very Old Patients with Arterial Hypertension without Frailty. Lechebnoe delo. 2019 1: 44–58. DOI: 10.24411/2071-5315-2019-12089 (in Russian).
21. Clinical guidelines. Senile asthenia. Russian Association of Gerontologists and Geriatrics (2018). http: //aggrb.ru/images/Doc/Asteniya_recomend.pdf (in Russian).
22. Clegg A, Young J, Iliffe S et al. Frailty in elderly people. Lancet 2013; 381 (9868): 752–62. DOI: 10.1016/S0140-6736 (12)62167-9
23. Collard RM, Boter H, Schoevers RA et al. Prevalence of frailty in community dwelling older persons: a systematic review. J Am Geriatr Soc 2012; 60 (8): 1487–92. DOI: 10.1111/j.1532-5415.2012.04054.x
24. Kojima G. Prevalence of frailty in nursing homes: A systematic review and metaanalysis. J Am Med Dir Assoc 2015; 16 (11): 940–95. DOI: 10.1016/j.jamda.2015.06.025
25. Buta BJ, Walston JD, Godino JG et al. Frailty assessment instruments: systematic characterization of the uses and contexts of highly-cited instruments. Ageing Res Rev 2016; 26: 53–61. DOI: 10.1016/j.arr.2015.12.003
26. Fried LP, Borhani NO, Enright P et al. The Cardiovascular Health Study: design and rationale. Ann Epidemiol 1991; 1: 263–76.
27. Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol Med Sci 2001; 56 (3): 146–56. DOI: 10.1093/gerona/56.3.m146
28. Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World J 2001; 1: 323–36. DOI: 10.1100/tsw.2001.58
29. Guralnik JM, Simonsick EM, Ferrucci L et al. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994; 49 (2): M85–94.
30. Guralnik JM, Ferrucci L, Simonsick EM et al. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med 1995; 332 (9): 556–61. DOI: 10.1056/NEJM199503023320902
31. Diehr P, Williamson J, Burke GL, Psaty BM. The aging and dying processes and the health of older adults. J Clin Epidemiol 2002; 55: 269–78.
32. Van Bemmel T, Holman ER, Gussekloo J et al. Low blood pressure in the very old, a consequence of imminent heart failure: the Leiden 85-plus Study. J Hum Hypertens 2009; 23: 27–32. DOI: 10.1038/jhh.2008.79
33. Muller M, Smulders YM, de Leeuw PW, Stehouwer CD. Treatment of hypertension in the oldest old: a critical role for frailty? Hypertension 2014; 63: 433–41. DOI: 10.1161/HYPERTENSIONAHA.113.00911
34. Benetos A, Rossignol P, Cherubini A et al. Polypharmacy in the aging patient: management of hypertension in octogenarians. JAMA 2015; 314 (2): 170–80. DOI: 10.1001/jama.2015.7517
35. Sabayan B, Oleksik AM, Maier AB et al. High blood pressure and resilience to physical and cognitive decline in the oldest old: the Leiden 85-plus study. J Am Geriatr Soc 2012; 60 (11): 2014–19. DOI: 10.1111/j.1532-5415.2012.04203.x
36. Benetos A, Gautier S, Labat C et al. Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjects: the PARTAGE (Predictive Values of Blood Pressure and Arterial Stiffness in Institutionalized Very Aged Population) study. J Am Coll Cardiol 2012; 60: 1503–11. DOI: 10.1016/j.jacc.2012.04.055
37. Benetos A, Labat C, Rossignol P 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 (6): 989–95. DOI: 10.1001/jamainternmed.2014.8012
38. Odden MC, Covinsky KE, Neuhaus JM et al. The association of blood pressure and mortality differs by selfreported walking speed in older Latinos. J Gerontol A Biol Sci Med Sci 2012; 67: 977–83. DOI: 10.1093/gerona/glr245
39. Ogliari G, Westendorp RG, Muller M et al. Blood pressure and 10-year mortality risk in the Milan Geriatrics 75+ Cohort Study: role of functional and cognitive status. Age Ageing 2015; 44: 932–7. DOI: 10.1093/ageing/ afv141
40. Mossello E, Pieraccioli M, Nesti et al. N Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs. JAMA Intern Med 2015; 175: 578–85. DOI: 10.1001/
jamainternmed.2014.8164
41. Van Hateren KJ, Hendriks SH, Groenier KH et al. Frailty and the relationship between blood pressure and mortality in elderly patients with type 2 diabetes (Zwolle Outpatient Diabetes project Integrating Available Care-34). J Hypertens 2015; 33 (6): 1162–6. DOI: 10.1097/HJH.0000000000000555
42. Sirola J, Pitkala KH, Tilvis RS et al. Definition of frailty in older men according to questionnaire data (RAND-36/SF36): The Helsinki Businessmen Study. J Nutr Health Aging 2011; 15: 783–7.
43. Chang YW, Chen WL, Lin FG et al. Frailty and its impact on health-related quality of life: a cross-sectional study on elder community-dwelling preventive health service users. PLoS One 2012; 7: e038079. DOI: 10.1371/journal.pone.0038079
44. Mansur HN, Colugnati FA, Grincenkov FR, Bastos MG. Frailty and quality of life: a cross-sectional study of Brazilian patients with predialysis chronic kidney disease. Health Qual Life Outcomes 2014; 12: 27. DOI: 10.1186/1477-7525-12-27
45. Odden MC, Peralta CA, Haan MN, Covinsky KE. Rethinking the association of high blood pressure with mortality in elderly adults: the impact of frailty. Arch Intern Med 2012; 172 (15): 1162–8. DOI: 10.1001/archinternmed.2012.2555
46. Fratiglioni L, Viitanen M, Backman L et al. Occurrence of dementia in advanced age: the study design of the Kungsholmen Project. Neuroepidemiology 1992; 11 (Suppl. 1): 29–36. DOI: 10.1159/000110958
47. Guo Z, Viitanen M, Winblad B. Low blood pressure and five-year mortality in a Stockholm cohort of the very old: possible confounding by cognitive impairment and other factors. Am J Public Health 1997; 87 (4): 623–8. DOI: 10.2105/ajph.87.4.623
48. Post Hospers G, Smulders YM, Maier AB et al. Relation between blood pressure and mortality risk in an older population: role of chronological and biological age. J Intern Med 2015; 277 (4): 488–97. DOI: 10.1111/joim.12284
49. Satish S, Zhang DD, Goodwin JS. Clinical significance of falling blood pressure among older adults. J Clin Epidemiol 2001; 54 (9): 961–7.
50. Anker D, Santos-Eggimann B, Santschi V et al. Screening and treatment of hypertension in older adults: less is more? Public Health Rev 2018; 3 (39): 26. DOI: 10.1186/s40985-018-0101-z. eCollection 2018
51. Ravindrarajah R, Hazra NC, Hamada S et al. Systolic blood pressure trajectory, frailty, and all-cause mortality > 80 years of age: cohort study using electronic health records. Circulation 2017; 135 (24): 2357–68. DOI: 10.1161/CIRCULATIONAHA.116.026687
Авторы
О.Д. Остроумова*1, М.С. Черняева2, А.П. Морозов2
1ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2ГБУЗ «Госпиталь для ветеранов войн №2» Департамента здравоохранения г. Москвы, Москва, Россия
*ostroumova.olga@mail.ru
1Pirogov Russian National Research Medical University, Moscow, Russia;
2Hospital for War Veterans №2, Moscow, Russia
*ostroumova.olga@mail.ru
1ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия;
2ГБУЗ «Госпиталь для ветеранов войн №2» Департамента здравоохранения г. Москвы, Москва, Россия
*ostroumova.olga@mail.ru
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1Pirogov Russian National Research Medical University, Moscow, Russia;
2Hospital for War Veterans №2, Moscow, Russia
*ostroumova.olga@mail.ru
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