Selected Geriatric Problems
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| The aging CV system | Decreased atrial compliance, increased S BP, loss of beta-adrenergic responsiveness, lowered barorecptor sensitivity, CO decreased with exercise compared to younger people
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| ___ % of pts 75 and over have HTN | 70%
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| HTN also associated with | vascular dementia, stroke, erectile dysfunction adn nephropathy
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| Isolated systolic HTN | is common in elderly and is a predictor of adverse CV events“underwear theory” of arterial stiffness leads to inflammation, fibrosis, smooth muscle hypertrophy
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| ___ is a greater predictor of adverse events than SBP or DBP | Widened Pulse Pressure; >40
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| ___ study showed that people over 80 with a SBP equal or greater to 160 benefit greatly from a thiazide diuretic and ACEI | HYVET
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| Treatment of the group of older pts with SBP <160 is | controversial
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| Prevalence of postprandial HTN in elderly. | 26%. possibly due to blood being pulled into the splanchnic vessels
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| Tx of HTN in elderly | First line: Thiazide diuretics. Then BB, ACEI or ARB, CCBs
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| Common AE of BB | depression
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| Avoid Thiazide's in pts with | renal failure, incontinence
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| Choose _____ for pts with CHF, DM, CRF | ACEI or ARB
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| Avoid BB in pts with | COPD, claudication, conduction, abnormalities, depression
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| how to treat HTN in patients with BPH | May use alpha blockers
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| Atypical presentation of Coronary Artery Disease | Dyspnea, Fatigue, Acute confusion, Chest Pain may not occur
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