Abstract:
OBJECTIVES:To estimate outcomes according to attained blood pressure (BP) in the oldest adults treated for hypertension in routine family practice. DESIGN:Cohort analysis of primary care inpatient and death certificate data for individuals with hypertension. SETTING:Primary care practices in England (Clinical Practice Research Datalink). PARTICIPANTS:Individuals aged 80 and older taking antihypertensive medication and free of dementia, cancer, coronary heart disease, stroke, heart failure, and end-stage renal failure at baseline. MEASUREMENTS:Outcomes were mortality, cardiovascular events, and fragility fractures. Systolic BP (SBP) was grouped in 10-mmHg increments from less than 125 to 185 mmHg or more (reference 145-154 mmHg). RESULTS:Myocardial infarction hazards increased linearly with increasing SBP, and stroke hazards increased for SBP of 145 mmHg or greater, although lowest mortality was in individuals with SBP of 135 to 154 mmHg. Mortality of the 13.1% of patients with SBP less than 135 mmHg was higher than that of the reference group (Cox hazard ratio=1.25, 95% confidence interval=1.19-1.31; equating to one extra death per 12.6 participants). This difference in mortality was consistent over short- and long-term follow-up; adjusting for diastolic BP did not change the risk. Incident heart failure rates were higher in those with SBP less than 125 mmHg than in the reference group. CONCLUSION:In routine primary care, SBP less than 135 mmHg was associated with greater mortality in the oldest adults with hypertension and free of selected potentially confounding comorbidities. Although important confounders were accounted for, observational studies cannot exclude residual confounding. More work is needed to establish whether unplanned SBPs less than 135 mmHg in older adults with hypertension may be a useful clinical sign of poor prognosis, perhaps requiring clinical review of overall care.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Delgado J,Masoli JAH,Bowman K,Strain WD,Kuchel GA,Walters K,Lafortune L,Brayne C,Melzer D,Ble A,As part of the Ageing Well Programme of the NIHR School for Public Health Research, England.doi
10.1111/jgs.14712subject
Has Abstractpub_date
2017-05-01 00:00:00pages
995-1003issue
5eissn
0002-8614issn
1532-5415journal_volume
65pub_type
杂志文章abstract:OBJECTIVE:The impact of cognitive function and decline on political ideology is unknown. We studied the relationship between cognition and both political orientation and political policy choices in a population of older persons. DESIGN:Longitudinal investigation. SETTING:A retirement community and its surroundings in...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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abstract:OBJECTIVES:To evaluate changes in acute health services use of Senior PharmAssist participants. DESIGN:Retrospective analysis. SETTING:Community-based, nonprofit program in Durham County, North Carolina. PARTICIPANTS:Adults aged 60 and older with income of 200% of the federal poverty level or less who enrolled in th...
journal_title:Journal of the American Geriatrics Society
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abstract:OBJECTIVE:To determine whether older people who use nonsteroidal anti-inflammatory agents (NSAIDs) have increased levels of blood urea nitrogen (BUN), serum creatinine, and BUN:serum creatinine ratio. DESIGN:Cross-sectional, secondary data analysis. SETTING:Older people living in the communities of East Boston, MA, N...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb02561.x
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:Recent studies have suggested that vascular dementia in older persons is more common than previously hypothesized. A substantial proportion of dementia in old age may be an early manifestation of cerebrovascular disease (CVD), that eventually becomes clinically evident as an acute cerebrovascular accident. Th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb00908.x
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:To identify the prevalence of hypertension and factors associated with nontreatment and poor control of hypertension in Mexican Americans aged 65 years and older. DESIGN:A population-based survey of older Mexican Americans conducted in 1993-1994. SETTING:Subjects residing in five Southwestern states: Texas,...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1998.tb02458.x
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVES:To test the effects of a communication skills training intervention on older patients' discourse during a primary care interview. DESIGN:A quasi-experimental design involving two intervention conditions. SETTING:The Family Practice Center of a university-based clinic. PARTICIPANTS:Thirty-three patients av...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.4911244.x
更新日期:2001-11-01 00:00:00
abstract::All living beings are at risk for experiencing infections; humans are no exception. The prestige and credibility of modern medicine is built in large part on achievements in preventing and treating infectious diseases. For most of human history, there was little that could be done to prevent and treat infections. Mill...
journal_title:Journal of the American Geriatrics Society
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abstract::Physical health problems become more common as people age and are associated with a great deal of disability. Although racial and ethnic disparities have been reported in physical health, little is known about whether these disparities remain in the latest part of older adulthood. Accordingly, the current study sought...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.03033.x
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To investigate whether a marked decrease in postprandial systolic blood pressure correlates with a higher incidence of falls, syncope, new coronary events, new stroke, and total mortality at long-term follow-up in older nursing home residents. DESIGN:In a prospective study of 499 nursing home residents aged ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb05965.x
更新日期:1997-09-01 00:00:00
abstract::Low-income Latino immigrants are understudied in elder abuse research. Limited English proficiency, economic insecurity, neighborhood seclusion, a tradition of resolving conflicts within the family, and mistrust of authorities may impede survey research and suppress abuse reporting. To overcome these barriers, promoto...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04025.x
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To identify specific characteristics of patients, physicians, and treatment settings associated with decreased receipt of essential medications in a chronically ill, older population following a Medicaid three-prescription monthly reimbursement limit (cap). DESIGN:Quasi-experiment with bivariate and multivar...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49158.x
更新日期:2001-06-01 00:00:00
abstract::Because of adverse publicity regarding increased risk of endometrial cancer in women receiving estrogen therapy, a 2-year prospective study was conducted in 1976 to determine the incidence of endometrial cancer in postmenopausal women. A retrospective study for the year 1975 was also added. A postmenopausal survey c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb01673.x
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVES:To explore and deepen understanding of factors influencing driving exposure for older drivers. DESIGN:Cross-sectional. SETTING:Baseline data on function and driving exposure from 1 week of driving were evaluated. PARTICIPANTS:A convenience sample of 380 drivers aged 75 and older, residing in northwest Syd...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13440
更新日期:2015-06-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13346
更新日期:2015-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb04746.x
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:To identify age-related differences in the treatment of patients with acute myocardial infarction. DESIGN:Retrospective cohort study. SETTING:Two university-affiliated medical centers with integrated clinical programs. PATIENTS:329 patients admitted with acute myocardial infarction in 1988-1990 for whom co...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.1994.tb06553.x
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVES:To determine if poorer healthcare and financial decision making forecasts adverse cognitive outcomes in old age. Specifically, we hypothesized that poorer decision making would be associated with an increased risk of incident Alzheimer's dementia, an increased risk of incident mild cognitive impairment (MCI)...
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pub_type: 杂志文章
doi:10.1111/jgs.15880
更新日期:2019-08-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2005.53502.x
更新日期:2005-10-01 00:00:00
abstract::The current literature on suicide by medicinal overdose among the elderly population of the United States and Britain is discussed. The older white male is a high risk in this regard. Physical and mental illnesses contribute to the problem of suicide among the aged, and some of the drugs prescribed for treatment (e.g....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1975.tb00218.x
更新日期:1975-07-01 00:00:00
abstract::Delirium is a common and serious condition that is underrecognized in older adults in a variety of healthcare settings. It is poorly recognized because of deficiencies in provider knowledge and its atypical presentation. Early recognition of delirium is warranted to better manage the disease and prevent the adverse ou...
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pub_type: 杂志文章,评审
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更新日期:2013-11-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1994.tb01760.x
更新日期:1994-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-08-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVES:To estimate the prevalence of prefrailty, frailty, comorbidity, and disability in the youngest old and to identify chronic diseases associated with individual frailty criteria. DESIGN:Population-based cohort study of noninstitutionalized elderly adults at baseline; cross-sectional analysis. SETTING:Lausann...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2012.04113.x
更新日期:2012-09-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.1996.tb06405.x
更新日期:1996-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2004.52117.x
更新日期:2004-03-01 00:00:00
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更新日期:2016-08-01 00:00:00
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doi:10.1111/jgs.13665
更新日期:2015-10-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06599.x
更新日期:1994-09-01 00:00:00