Screening for hypertension-mediated organ damage and aetiology: still of value after 65 years of age?
Delphine Thiolliere1
Brahim Harbaoui2
Claire Falandry3
Marc Bonnefoy3
Jean-Christophe Lega4
Pierre Lantelme2
Pierre-Yves Courand2
1.Fédération de cardiologie,H?pital de la Croix-Rousse et H?pital Lyon Sud,Hospices Civils de Lyon,Lyon,France2.Fédération de cardiologie,H?pital de la Croix-Rousse et H?pital Lyon Sud,Hospices Civils de Lyon,Lyon,France;Université de Lyon, CREATIS; CNRS UMR5220;INSERM U1044;INSA-Lyon;Université Claude Bernard Lyon,France3.Service Universitaire de Gériatrie,H?pital Lyon Sud,Hospices Civils de Lyon,Lyon,France;CarMeN,Uni-versité Claude Bernard Lyon 1,Oullins,France4.Service de médecine interne et pathologies vasculaires,Groupe d'Et-ude Multidisciplinaires des Maladies Thrombotiques(GEMMAT),H?pital Lyon Sud,Hospices Civils de Lyon,Lyon,France;Universitéde Lyon,Equipe Evaluation et Modélisation des Effets Thérapeutiques,Laboratoire de Biologie et Biométrie Evolutive,CNRS UMR 5558,Université Claude Bernard,Lyon,France
摘要：BACKGROUND Secondary forms and hypertension-mediated organ damage (HMOD) may differ between younger and older hypertensive patients. The aim of the present study was to explore the specificity of HMOD and secondary forms in patients ≥ 65 years in comparison to younger ones in a contemporary cohort.METHODS We analysed 938 patients recruited between 2004 and 2014 (Cardiology department, Croix-Rousse Hospital, Lyon) who had at baseline HMOD and secondary forms screening among them 190 were ≥ 65 years. RESULTS The mean (2.1 ± 0.8 vs. 1.2 ± 0.9, P < 0.001) and frequency of HMOD (96.3％ vs. 72.9％, P < 0.001) was higher in pa-tients ≥ 65 years than younger ones. Carotid femoral pulse wave velocity > 10 m/s was the most frequent HMOD in patients ≥ 65 years (90.1％), while echocardiographic left ventricular hypertrophy was the most common in the younger patients (45.0％). Among ECG left ventricular indexes, only R wave in aVL lead was significantly more frequently observed in patients ≥ 65 years (32.6％) than in younger ones (19.0％, P < 0.001). The frequency of secondary hypertension was not significantly different between younger and older patients (respectively; 30.5％ vs. 27.8％, P = 0.487). The most frequent aetiology was primary aldosteronism re-gardless of age, followed by renovascular hypertension (6.3％ vs. 3.3％, P = 0.038). Among older patients, 3.2％ were treated with adrenalectomy and 6.3％ with percutaneous transluminal renal angioplasty. CONCLUSION Extensive screening of HMOD in older patients may be questionable as nearly all patients had one; aetiology must however be explored as a third of older patients had a secondary form.
机标关键词：hypertensionscreeningstilldamageafteraetiologymediatedorgan
论文发表日期：2022-11-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：11( 791-801 )