Key result
The authors argue that severe frailty and dementia should be explicitly considered when deciding on intensive blood pressure therapy in older adults, advocating for an individualized approach.
Why the study?
Should advanced age, frailty, and dementia be considered when deciding on intensive blood pressure therapy in older patients?
Should advanced age, frailty, and dementia be considered when deciding on intensive blood pressure therapy in older patients?
The commentary argues that severe frailty and dementia should be considered when deciding on intensive blood pressure therapy in older patients, challenging the 2017 Hypertension Canada guidelines.
In 2017, Hypertension Canada removed advanced age and frailty as considerations for caution when deciding on intensive therapy in their guidelines for the diagnosis, risk assessment, prevention, and treatment of hypertension in adults. Dementia is not mentioned. In this commentary, we review why advanced age and frailty were removed, and examine what is currently known about the relationship between hypertension and both incident and prevalent dementia. We make the case that the presence of frailty (especially when severe) and dementia should be considered when deciding on intensive therapy in future iterations of Hypertension Canada guidelines.
No takes yet. Share an insight, caveat, or question.
Giffin et al. (2020) conducted a review in Hypertension. Intensive blood pressure therapy vs. Standard blood pressure therapy was evaluated. The authors argue that severe frailty and dementia should be explicitly considered when deciding on intensive blood pressure therapy in older adults, advocating for an individualized approach.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: