BELGIUM 27th !!! 1) HTA DE GRADE 3 = TOUJOURS RISQUE > ELEVE 4 - PowerPoint PPT Presentation

BELGIUM 27th !!!

1) HTA DE GRADE 3 = TOUJOURS RISQUE > ELEVE

4 3 2) PREVENTION SECONDAIRE ou DIABETE + ATTEINTE ‘ORGANE CIBLE’/FACTEUR DE RISQUE = RISQUE ELEVE PEU IMPORTE LA PA

3) Si PAS >140 et/ou 90 mmHg et  >3 facteurs de risque CV = RISQUE ELEVE  ou atteinte ‘organe cible’  ou diabète

LI LIFE E EXPECTANCY A AT 60 Y YRS I IN 2012

Ph van de Borne, L Missault, A Persu, W Van Mieghem for the COME STAI INVESTIGATORS

RESULTS (2): Nr of medications reported in n:7961 patients (0 vs. 1 vs. 2 or more drugs) Param eters 0 > 2 1 m edication m edications m edication Systolic BP 139 ± 19 139 ± 18 143 ± 21* (m m Hg) Diastolic BP 8 0 ± 11 8 1 ± 11 8 3 ± 13* (m m Hg) Age 68 ± 12 62 ± 13 55 ± 15* (years) Heart rate 72 ± 10 73 ± 9 75 ± 10 * (bpm ) Body m ass 29.0 ± 5.8 27.2 ± 5.0 26.7 ± 5.2* index (kg/ m ² ) S: systolic; D: diastolic; BP: Blood pressure; bpm: beat per minute; * p<0.0001

Less intense treatm ent in the elderly : Among 495 patients aged ≥80 years, and SBP> 140 mmHg, therapy was intensified: in 57% when SBP > 160 mmHg (n=130) in 17% when 140 <SBP<159 mmHg* (n=365) *p Chi² <0.0001

Blood pressure in ESH/ ESC ASH/ ISH Go A. et al. 20 14 Hypertension m m Hg 20 13[3] 20 14 [4] AHA/ ACC/ CDC 20 13 [5] guidelines, US “JNC 8 ” [6] ≥140/90 ≥140/90 ≥140/90 Definition of Not addressed Hypertension ≥140/90 ≥140/90 ≥140/90 < 60 y. ≥140/90 Drug therapy in low risk patients after non- ≥ 60 y. ≥150/90 pharm acologic treatm ent Beta-blockers as first line Yes No No No drug (Step 4) (Step 3) (Step 4) Diuretic thiazides thiazides thiazides thiazides chlorthalidone, chlorthalidone chlorthalidone, indapam ide indapam ide indapam ide ≥160/100 ≥160/100 ≥160/100 Initiate drug therapy with two If m arkedly elevated drugs BP Blood pressure targets <140 / 90 <140 / 90 <140 / 90 < 60 y. <140 / 90 Elderly < 8 0 y. Lower targets m ay be ≥ 80 y. ≥ 60 y. <150/90 SBP 140 -150 appropriate in som e SBP <140 in fit < 150 / 90 patients, including the patients elderly Elderly ≥ 80 y. SBP 140 -150 Blood Pressure target in < 140 / 8 5 <140 / 90 <140 / 90 <140 / 90 patients with diabetes Lower targets m ay be m ellitus considered