Should we Rethink Intensifying Blood Pressure Treatment for Lower Elderly Patients? |
|
There has been increasing interest in answering the question of the proper blood pressure control for older adults. The hypertension and the very elderly trial (HYVET) and the systolic blood pressure intervention trial (SPRINT) are the largest trials to examine the effectiveness of antihypertensive treatment in persons 80 and older. There was strong evidence that reduction of systolic blood pressure from 160 mmHg to 150 mmHg reduces the risk of CVD, heart failure and death from any cause in the HYVET study. This SPRINT trial took it down further to 120 mmHg and showed reduced risk of CVD and death which was sustained in a support group for participants age 80 and older.
The most recent study published in the Journal of the American Geriatric Society, Shephard et al. conducted a cross sectional study in 24 general practices in England. They have identified over 15,000 patients, of which 268 were eligible for the HYVET trial criteria, 5290 were eligible for the SPRINT trial criteria, and 3940 patients were eligible for the one medication reduction trial (OPTiMISE) criteria. The authors concluded that no trial evidence exists to inform treatment decisions in routine practices and caution should be exercised on applying results from such trials 1.
In an accompanying editorial2, Dr. Williamson argues that Dr. Shepherd and his colleagues’ findings that approximately 34% of adults over the age of 80 would be eligible for hypertension guidelines based on the SPRINT trial. This is not a small percentage. The American Heart Association/the American College of Cardiology BP control guidelines try to assist clinicians caring for older adults by recognizing that such patients have a high burden of comorbidity and life limiting factors, and clinical judgment as well as patient preference will have to inform the decision of whether or not intensifying BP lowering would be appropriate.
Any views or opinions presented in this article are solely those of the author and do not necessarily represent any policy or position of PAMED, PMDA, AMDA, its affiliates and members.
|
|
Current Postings
BC/BE Internal Medicine, Family Medicine or Geriatric Physician - $20,000 Signing Bonus!
Adfinitas Health | Scranton/Wilkes-Barre Area, PA
BC/BE Geriatrician
Full-Time | Penn Medicine, Lancaster General Health
Geriatrician
Lehigh Valley Health Network
|
|
|
|
The PMDA Trainee Education Fund supports PMDA’s efforts to educate, recognize and inspire post-acute and long-term care clinicians in training in the benefits and rewards of a career in the PALTC continuum. Your contribution will allow us to continue to offer complimentary registration to the Annual Symposium for fellows, residents and students and support PMDA’s contribution to AMDA’s Futures Program. Help us invest in the future of practice in PALTC medicine. |
|
PMDA's Spring 2020 Conference on Post-Acute and Long-term Care Issues in the Era of COVID-19 Available for Download |
|
PMDA has packaged the conference presentations and PowerPoints for easy access to the important topics covered during the 2020 virtual spring conference, including:
- Advanced Care Planning and Breaking Bad News presented by Alexander Nesbitt, MD
- Transitions of Care in the Era CO of VID-19 presented by Firas Saidi, MD, CMD
- Telemedicine, New COVID Codes and Modifiers presented by Michael Owen, PA-C
- Outbreak Management in the LTC Setting/PPE/ Lessons Learned presented by Joshua Uy, MD
Each recording is $15 plus 6% sales tax.
|
|
Core Curriculum Now Available On-Demand
The Society's Core Curriculum on Medical Direction in PALTC is the only program of its kind, offering comprehensive instruction on management and leadership within the PALTC setting. The Online Core, the first part of the three-part program, is now available on-demand so you can start and finish on your schedule. The Core Synthesis, the third part of the program, is offered in both in-person and virtual formats.
|
Discuss COVID-19, Other Important Topics at PALTC21 (March 11-14) |
Make sure and register for PALTC21, AMDA’s Annual Conference, being held virtually March 11-14, 2021. The agenda features the topics on the minds of practitioners everywhere, including a special COVID-19 track. But beyond COVID, the program is chock full of issues from telemedicine/technology, advance care planning, and oral care to the latest PALTC research, cross-cultural care, quality improvement, and LTC leadership.
There also will be the popular Saturday session focusing on public policy and other programs on regulatory, reimbursement, and additional key issues. Join AMDA to receive the member rate!
|
Join the AHRQ ECHO National Nursing Home COVID-19 Action Network
Project ECHO is actively recruiting nursing homes around the country to join an interactive community of practice to collaboratively advance improvements in COVID-19 preparedness, safety, and infection control.
Nursing homes can join through their local training center or by using the link below. If you have enrolled with a training center, there is no need to fill out this form.
|
The COVID-19 Vaccine: We’ve Got It, We’re Giving it…What Now?
Date: January 13, 2021
Time: 7:00 – 8:00 PM ET
What’s in Your Medical Director Agreement? Negotiating the Terms and Understanding Key Provisions
Date: January 27, 2021
Time: 2:00 – 3:00 PM ET
|
Recently Archived Webinars |
|
AMDA On-The-Go
Podcast Series
|
(12-30-20)
(12-17-20)
(12-07-20)
(12-05-20)
|
AMDA membership is not required to access AMDA’s COVID-19 Vaccination Toolkit, however you will need to create an account (which is free) if you don’t already have one.
|
|
|
|
|
|
|
