PROFILE OF ELDERLY HYPERTENSIVE PATIENTS IN NEPHROLOGYCONSULTATION: ABOUT 61 CASES

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Objective: Hypertension is a cardiovascular risk factor and a cause of morbidity and mortality, especially in elderly population. The aim of this work was studying the profile of elderly hypertensive patients, the associated risk factors and the proposed therapeutic modalities. Design and method: It was a retrospective descriptive study conducted in nephrology consultation from January 2020 to January 2022. Hypertensive patients over 65 years old were included. Cardiovascular risk was stratified according to the ESC 2019 recommendations. Chronic kidney disease (CKD) stage was defined according to the KDIGO classification. Therapeutic target was defined as Systolic Blood Pressure (SBP) <150mmHg. Results: Sixty-one patients were included,mean aged 72.5 years with a sex ratio M/F 1.25. The average age at the time of discovery of hypertension was 60.12 years [38-85]. Fifty-five patients were followed for nephropathy (90.16%). The dominant stages of CKD were 3 and 4 (in 28 and 12 patients respectively). Among our population, thirty-four patients were diabetic (55.73%), 21 were dyslipidemic (34.42%), 12 patients had coronary disease (19.67%) and seven patients were active smokers (11.47%). Among the diabetic patients, hypertension was considered as a diabetic macroangiopathy in 15 patients (44.11%). Metabolic syndrome was found in 21 patients (34.42%). Thirteen patients were classified as very high cardiovascular risk, 34 as high risk, and 9 as moderate risk. The mean SBP was 140mmHg+/-24.28. Vascular nephropathy was found in 28 patients (45.9%) and left ventricular hypertrophy in 3 patients (4.91%). The therapeutic target was achieved in 42 patients (68.85%) of whom 24 were on a calcium channel blocker, 28 were on a Renin-angiotensin-aldosterone (RAAS) blockers, 15 on a combination containing a loop diuretic and 10 on a central antihypertensive. Treatment complications requiring a change in therapy were orthostatic hypotension in 3 patients on a central antihypertensive and hyperkalemia with acute renal failure in five patients on a RAAS blockers. Conclusions: Hypertension in the elderly is associated with multiple comorbidities mainly diabetes. Regular follow-up of this population with adaptation of treatment is necessary to reduce mortality rate and prevent complications related to hypertension and treatment.

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