Hypertension of the old subject followed in nephrology

Abstract

We aimed: – to determine the frequency of high blood pressure in the elderly at different stages of chronic renal failure and; – to evaluate the antihypertensive therapeutic treatment in a nephrology environment. The patients were recruited in the consultation of nephrology; we included hypertensive subject aged of more than 65 years old followed by nephrologists. 292 patients were included: 53% women and 47% men, with an average age of 76.52 ± 6.45 years [66-97]. The average duration of the follow-up was 1.69 ± 0.94 years [1–5]. The duration of arterial hypertension was more than 10 years in 55% of cases. The patients were at different stages of renal failure: chronic incipient, chronic renal failure 4%, moderate 54% and severe to terminal renal failure 42%. Several pathologies were associated with arterial hypertension, namely: 50.3% of patients were diabetic, 39.2% had a cardiovascular pathology (22% AC/FA, 16% valve pathology, 31% heart failure, 31% IDM% sequels), 36% of patients had dyslipidemia and 25% had neoplasia. Antihypertensive quadritherapy was needed in 4% of cases, triple therapy in 22% of cases, dual therapy in 50% and single therapy in 24% of patients. The diuretics of the loop represents the most prescribed therapeutic class (63%), followed by blockers of the renin angiotensin system (47.5%), calcium channel blockers (24%), while the beta-blockers (23%) were often prescribed by the cardiologist. Older patients with renal pathology are often hypertensive. Hypertensive therapeutic management must be adequate to slowdown the progression of chronic renal failure as well as the worsening of other associated pathologies.