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Article Dans Une Revue Journal of Geriatric Cardiology Année : 2022

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

Résumé

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 patients ≥ 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 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 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.
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hal-04627755 , version 1 (27-06-2024)

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Delphine Thiolliere, Brahim Harbaoui, Claire Falandry, Marc Bonnefoy, Jean-Christophe Lega, et al.. Screening for hypertension-mediated organ damage and aetiology: still of value after 65 years of age?. Journal of Geriatric Cardiology, 2022, 19 (11), pp.791-801. ⟨10.11909/j.issn.1671-5411.2022.11.005⟩. ⟨hal-04627755⟩
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