CKD is highly prevalent in elderly hypertensive patients, and achieving strict guideline-directed blood pressure targets (<130/80 mmHg) is difficult in this population despite multiple medications.
Achieving strict BP targets remains challenging in elderly hypertensives with CKD; leaves open optimal strategies pending prospective trials.
OBJECTIVE: Hypertension guidelines recommend strict blood pressure (BP) control to less than 130/80 mmHg in patients complicated with chronic kidney disease (CKD). However, it is unclear whether this target BP level is applicable to the elderly hypertensive patients. The aim of this study was to assess the prevalence of CKD and BP control status in elderly hypertensive patients. METHODS: Subjects were 675 hypertensive patients (65.5 ± 11.7 years, 290 males and 385 females). Prevalence of CKD and BP control status were compared between elderly and young/middle-age patients. RESULTS: Average BP of elderly and young/middle-age patients were 134 ± 10/71 ± 9 mmHg and 131 ± 11/78 ± 9 mmHg, respectively. CKD was more prevalent in the elderly than in the young/middle-age patients (35.5% and 24.5%, respectively). The elderly patients with CKD were more likely to be males and older. They also required a greater number of antihypertensive drugs than those without CKD (2.4 ± 1.2 vs. 2.0 ± 1.1, p<0.01). Elderly patients without CKD who achieved a target BP of <140/90 mmHg were 73.2%. Similarly, 78.5% of the patients with CKD achieved BP of <140/90 mmHg, while those who achieved <130/80 mmHg were only 29.6%. CONCLUSION: Our results suggest that CKD is frequently complicated in elderly hypertensive patients, and many of them failed to achieve strict BP goal in spite of the average use of 2.4 antihypertensive drugs.
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Hasegawa et al. (2012) studied this question.
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