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Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension.

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Presentation on theme: "Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension."— Presentation transcript:

1 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Prevalence of High Blood Pressure in Adults by Age and Sex (NHANES 2005–2006) NHANES indicates The National Health and Nutrition Examination Survey.

2 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Extent of Awareness, Treatment, and Control of High Blood Pressure by Age (NHANES 2005–2006) NHANES indicates The National Health and Nutrition Examination Survey.

3 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Mean Blood Pressure According to Age and Ethnic Group in U.S. Adults

4 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Frequency of Untreated Hypertension According to Subtype and Age

5 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Joint Influences of Systolic Blood Pressure and Pulse Pressure on Coronary Heart Disease Joint influences of SBP and pulse pressure on CHD risk, from the Framingham Heart Study. CHD hazard ratio was determined from level of pulse pressure within SBP groups. Hazard ratios were set to a reference value of 1.0 for SBP values of 110, 130, 150, and 170 mm Hg, respectively. All estimates were adjusted for age, sex, body mass index, cigarettes smoked per day, glucose intolerance, and total cholesterol/high-density lipoprotein. The p values refer to the CHD hazard ratios determined from the level of pulse pressure within the SBP groups. CHD indicates coronary heart disease; SBP, systolic blood pressure.

6 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Age-Specific Prevalence of Hypertension in U.S. Adults (NHANES 1999–2004) MA indicates Mexican American; NHANES, The National Health and Nutrition Examination Survey; NHB, Non-Hispanic Black; and NHW, Non- Hispanic White.

7 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Conceptual Framework for Cardiovascular Adaptations to Arterial Stiffening That Occur With Aging CBF indicates coronary blood flow; DBP, diastolic blood pressure; EF, ejection fraction; LA, left atrial; LV, left ventricular; SBP, systolic blood pressure; ↑, increased; and ↓, decreased.

8 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Absolute Risk of Stroke Mortality in Relation to Blood Pressure (A) Systolic blood pressure. (B) Diastolic blood pressure. Stroke mortality rate in each decade of age versus usual blood pressure at the start of that decade. Rates are plotted on a floating absolute scale, and each square has area inversely proportional to the effective variance of the log mortality rate. For diastolic blood pressure, each age-specific regression line ignores the left-hand point (i.e., at slightly <75 mm Hg), for which the risk lies significantly above the fitted regression line (as indicated by the broken line below 75 mm Hg). The y-axis is logarithmic. CI indicates confidence interval.

9 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Risk of Adverse Outcomes by Age and Blood Pressure BP indicates blood pressure; DBP, diastolic blood pressure; and SBP, systolic blood pressure.

10 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Algorithm for Treatment of Hypertension in the Elderly ACEI indicates angiotensin-converting enzyme inhibitor; ALDO ANT, aldosterone antagonist; ARB, aldosterone receptor blocker; BB, beta blocker; CA, calcium antagonist; CAD, coronary artery disease; CVD, cardiovascular disease; DBP, diastolic blood pressure; RAS, renin- angiotensin system; SBP, systolic blood pressure; and THIAZ, thiazide diuretic.

11 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Absolute Risk of Ischemic Heart Disease Mortality in Relation to Blood Pressure (A) Systolic blood pressure. (B) Diastolic blood pressure. The Y axis is logarithmic. CI indicates confidence interval; IHD, ischemic heart disease.

12 Date of download: 9/17/2016 Copyright © The American College of Cardiology. All rights reserved. From: ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents Developed in Collaboration With the American Academy of Neurology, American Geriatrics Society, American Society for Preventive Cardiology, American Society of Hypertension, American Society of Nephrology, Association of Black Cardiologists, and European Society of Hypertension J Am Coll Cardiol. 2011;57(20):2037-2114. doi:10.1016/j.jacc.2011.01.008 Figure Legend: Percentage of People in Outcomes Trials of the Elderly Taking 2 or More Antihypertensive Medications ACCOMPLISH (8) indicates Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension; ALLHAT (9), Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial; Australian HTN (718), Australian Hypertension Study; CONVINCE (719), Controlled Onset Verapamil Investigation of Cardiovascular End Points Trial; EWPHE (12), European Working Party on High Blood Pressure in the Elderly; HYVET (4), Hypertension in the Very Elderly Trial; INVEST (584), International Verapamil-Trandolapril Study; LIFE (14), Losartan Intervention For Endpoint Trial; MRC-Elderly (15), Medical Research Council Trial of treatment of hypertension in older adults; SBP, systolic blood pressure; SHEP (16), Systolic Hypertension in the Elderly Program; STONE (17), Shanghai Trial of Hypertension in the Elderly; STOP-2 (720), Swedish Trial in Old Patients with Hypertension; Syst-China (19), Systolic Hypertension in China Trial; and Syst-Eur (20), Systolic Hypertension in Europe Trial.


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