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Blood Pressure, Antihypertensive Tre...

Liu, Xiaojuan,

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Blood Pressure, Antihypertensive Treatment, and Functional Status in Older Adults /

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Blood Pressure, Antihypertensive Treatment, and Functional Status in Older Adults // Xiaojuan Liu.
作者:	Liu, Xiaojuan,
面頁冊數:	1 electronic resource (174 pages)
附註:	Source: Dissertations Abstracts International, Volume: 86-04, Section: A.
Contained By:	Dissertations Abstracts International86-04A.
標題:	Cardiovascular disease. -
電子資源:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=31520299
ISBN:	9798342115667

Blood Pressure, Antihypertensive Treatment, and Functional Status in Older Adults /
Liu, Xiaojuan,

Blood Pressure, Antihypertensive Treatment, and Functional Status in Older Adults /Xiaojuan Liu. - 1 electronic resource (174 pages)

Source: Dissertations Abstracts International, Volume: 86-04, Section: A.

Hypertension management remains a challenging problem in older adults. Randomized clinical trials including relatively healthier older adults have shown benefits of intensive blood pressure control, while they have excluded nursing home residents. Intensive antihypertensive treatment may no longer be beneficial in this frail subpopulation given their vulnerability to adverse effects and shorter life expectancy. Consequently, antihypertensive deprescribing or discontinuation is of growing interest. However, limited evidence exists on the impact of antihypertensive deprescribing on patient-centered outcomes to guide clinical practice. On the other hand, functional status, which is defined as the levels of activities performed by an individual to realize the needs of daily living, emerges a focus in clinical care for older people. Gathering more data on the associations between antihypertensive treatment and functional status could inform personalized care plans and optimize treatment strategies. Moreover, a deeper understanding of the biological mechanisms and identification of translational biomarkers could shed light on the prevention of functional decline. This dissertation links together three diverse projects with the overarching goal to understand the relationships of blood pressure, antihypertensive treatment, cardiovascular and functional outcomes in nursing home residents and identify biomarkers and mechanisms underlying physical functional decline over life course. To achieve this, we leverage multiple data sources, advanced platforms, and a variety statistical and epidemiological methods in these projects. First, we assessed the associations of systolic blood pressure level with cardiovascular and mortality risk in Veterans Affairs (VA) nursing home residents and uncovered that these associations varied by the intensity of antihypertensive medications. Second, we leveraged VA electronic health records and emulated a target trial on antihypertensive deprescribing and found that deprescribing antihypertensive medication did not adversely affect functional status. Finally, we performed a proteomic analysis and identified a novel set of plasma proteins associated with functional decline in gait speed and grip strength from middle to old age. Collectively, these studies could contribute to an enhanced understanding of the hypertension management in older nursing home residents, as well as the biological mechanisms of physical decline to inform the health improvements and shared decision-making in the older population.

English

ISBN: 9798342115667Subjects--Topical Terms:

3564561
Cardiovascular disease.

Blood Pressure, Antihypertensive Treatment, and Functional Status in Older Adults /
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