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Screening for hypertension-mediated organ damage and aetiology:still of value after 65 years of age?

Journal of Geriatric Cardiology 2022年第11期19卷 791-801页

作者： Delphine Thiolliere Brahim Harbaoui claire falandry Marc Bonnefoy Jean-Christophe Lega Pierre Lantelme Pierre-Yves Courand Fédération de cardiologie Hôpital de la Croix-Rousse et Hôpital Lyon SudHospices Civils de LyonLyonFrance Universitéde Lyon CREATISCNRS UMR5220INSERM U1044INSA-LyonUniversitéClaude Bernard LyonFrance Service Universitaire de Gériatrie Hôpital Lyon SudHospices Civils de LyonLyonFrance CarMeN UniversitéClaude Bernard Lyon 1OullinsFrance Service de médecine interne et pathologies vasculaires Groupe d’Etude Multidisciplinaires des Maladies Thrombotiques(GEMMAT)Hôpital Lyon SudHospices Civils de LyonLyonFrance Universitéde Lyon Equipe Evaluation et Modélisation des Effets ThérapeutiquesLaboratoire de Biologie et Biométrie EvolutiveCNRS UMR 5558UniversitéClaude BernardLyonFrance

BACKGROUND Secondary forms and hypertension-mediated organ damage(HMOD) may differ between younger and older hypertensive *** 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 *** 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 *** The mean(2.1±0.8 vs.1.2±0.9,P 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 regardless 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 *** 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.

关键词： 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

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