{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T08:06:45Z","timestamp":1663142805969},"reference-count":0,"publisher":"PAGEPress Publications","issue":"1-2","license":[{"start":{"date-parts":[[2016,6,22]],"date-time":"2016-06-22T00:00:00Z","timestamp":1466553600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Monaldi Arch Chest Dis"],"abstract":"<jats:p>The prevalence of hypertension increases with the age. Diagnostic criteria are the same as for the young, but in older adults isolated systolic hypertension is more frequent, due to loss of vascular compliance. Blood pressure should be measured on both sides in the seated position, moreover in the supine and upright position to detect orthostatic hypotension. Ambulatory blood pressure monitoring is useful to detect white coat hypertension and masked hypertension, to tailor the treatment and search for diurnal and nocturnal blood pressure pattern abnormalities. Given that frailty can affect the relationship between blood pressure and mortality, the clinician should properly evaluate and monitor physical performance and cognitive status, throughout specific tools, as the Fried Frailty Phenotype, aiming at a systolic blood pressure target between 130 and 150 mmHg. Before starting hypotensive drugs, a careful risk and benefits\u00e2\u20ac\u2122 evaluation should be performed given the high risk of hypertension and hypotension consequences and the frequent coexistence of orthostatic hypotension, which predisposes to syncope and falls.\u00c2\u00a0\u00c2\u00a0RiassuntoLa prevalenza dell\u00e2\u20ac\u2122ipertensione arteriosa aumenta con l\u00e2\u20ac\u2122et\u00c3\u00a0. I criteri diagnostici sono gli stessi previsti nel giovane, nell\u00e2\u20ac\u2122anziano tuttavia si osserva pi\u00c3\u00b9 frequentemente ipertensione sistolica isolata, dovuta a perdita dell\u00e2\u20ac\u2122elasticit\u00c3\u00a0 vascolare. Ai fini diagnostici, la misurazione della pressione arteriosa bilateralmente in posizione seduta, deve essere integrata con la ricerca di ipotensione ortostatica. Il monitoraggio della pressione arteriosa nelle 24h \u00c3\u00a8 indicato per la conferma diagnostica, per la ricerca di \u00e2\u20ac\u0153white coat hypertension\u00e2\u20ac\u009d e \u00e2\u20ac\u0153masked hypertension\u00e2\u20ac\u009d, per monitorare la risposta terapeutica e ricercare alterazioni del ritmo circadiano. I benefici della terapia antiipertensiva sono noti, tuttavia un trattamento troppo aggressivo si \u00c3\u00a8 dimostrato dannoso, rendendo la gestione dell\u00e2\u20ac\u2122ipertensione arteriosa nell\u00e2\u20ac\u2122anziano ancora pi\u00c3\u00b9 complessa. Data l\u00e2\u20ac\u2122influenza della fragilit\u00c3\u00a0 sulla relazione tra pressione arteriosa e mortalit\u00c3\u00a0, il clinico dovrebbe avvalersi di adeguati strumenti per la definizione di performance fisica e cognitiva ed il monitoraggio nel tempo, mirando ad un target di pressione arteriosa sistolica compreso tra 130 e 150 mmHg. Rischi e benefici della terapia antiipertensiva dovrebbero essere attentamente valutati prima di intraprendere un trattamento, data la possibilit\u00c3\u00a0 di eventi correlati sia all\u00e2\u20ac\u2122ipertensione che all\u00e2\u20ac\u2122ipotensione e la frequente coesistenza di ipotensione ortostatica, che incrementa il rischio di eventi sincopali e cadute. Nell\u00e2\u20ac\u2122anziano iperteso con storia di sincope e cadute il trattamento dovrebbe quindi essere intrapreso una volta confermata la diagnosi, mirando ad un target pressorio pi\u00c3\u00b9 contenuto e con una scelta ponderata dei principi attivi.<\/jats:p>","DOI":"10.4081\/monaldi.2015.729","type":"journal-article","created":{"date-parts":[[2016,6,23]],"date-time":"2016-06-23T18:50:51Z","timestamp":1466707851000},"source":"Crossref","is-referenced-by-count":1,"title":["High blood pressure and syncope: orthostatic hypotension as a link"],"prefix":"10.4081","volume":"84","author":[{"given":"Martina","family":"Rafanelli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ungar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2016,6,22]]},"container-title":["Monaldi Archives for Chest Disease"],"original-title":[],"link":[{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/download\/729\/709","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/download\/729\/709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T12:07:35Z","timestamp":1655986055000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.monaldi-archives.org\/index.php\/macd\/article\/view\/729"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,22]]},"references-count":0,"journal-issue":{"issue":"1-2","published-online":{"date-parts":[[2016,6,22]]}},"URL":"https:\/\/doi.org\/10.4081\/monaldi.2015.729","relation":{},"ISSN":["2532-5264","1122-0643"],"issn-type":[{"value":"2532-5264","type":"electronic"},{"value":"1122-0643","type":"print"}],"subject":[],"published":{"date-parts":[[2016,6,22]]}}}