Key result
Hypertension management in frail older adults remains an evidence gap due to unclear treatment benefits.
Why the study?
Hypertension management is challenging in frail older adults due to vulnerability to adverse events, debated blood pressure targets, and limited evidence to guide clinical decisions.
This narrative review highlights the lack of evidence regarding optimal blood pressure targets and frailty assessment in older hypertensive patients, emphasizing the need for future research.
Evidence gap precludes firm BP targets in frail older adults; leaves open frailty-adjusted strategies for dedicated trials.
Hypertension management is challenging in frail older adults. The balance between treatment risks and benefits may be difficult to achieve due to an increased vulnerability to treatment-related adverse events, and limited evidence is available to support clinical decisions. The effects of frailty on blood pressure are unclear, as well as its impact on antihypertensive treatment benefits. Appropriate blood pressure targets in frail patients are debated and the frailty measure which best inform clinical decisions in hypertensive patients has yet to be identified. Therefore, hypertension management in frail older adults still represents a 'gap in evidence'. Knowledge of currently available literature is a fundamental prerequisite to develop future research and may help to implement frailty assessment and improve hypertension management in this vulnerable population. Given these premises, we present a narrative review illustrating the most relevant issues that are a matter of debate and that should be addressed in future studies.
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Rivasi et al. (2020) conducted a review in Hypertension in frail older adults. Hypertension management in frail older adults remains a gap in evidence due to unclear effects of frailty on blood pressure and treatment benefits, highlighting the need for future research.
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