The influence of hypertension management on frailty prevention among older persons aged 65 and over: a systematic review.

BACKGROUND: Frailty and hypertension are interrelated, but it remains unclear whether this relationship is modified by antihypertensive drugs. METHODS AND RESULTS: A systematic review of PubMed and Web of Science databases was performed to review the influence of hypertension management on preventing the occurrence or progression of frailty in older people aged 65 and over. Studies providing information on this association regardless of the study setting, or definition of hypertension and frailty were included. Among the initial 2298 articles identified, 7 were included in the review. Three observational studies assessed the association between frailty and hypertension. Two of them reported no relationship between Aldosterone Antagonists use and frailty prevention. No relationship between BP and incidence frailty after adjustment for hypertension treatment was observed in two other articles. An indirect relationship was reported in the RCTs included. Higher AT11RaAb levels (control group), can lead to a generalized weakness/frailty risk shown by a decrease in grip strength (r = -0.57, p < 0.005) and walking speed (r = - 0.47, p < 0.005). No significant differences between int-hypertensive intervention and control were observed in frailty status after a 12-weeks follow-up after applying three different frailty measurement tools in the other RCT. CONCLUSIONS: Based on the results of this systematic review we conclude that BP and frailty occur together but whether the treatment with anti-hypertensive drugs modifies this relationship remains unclear and needs to be further investigated.

Prevalence and types of potentially inappropriate prescriptions among older and middle-aged community-dwelling Albanian patients.

BACKGROUND: Prevalence of potentially inappropriate prescriptions (PIP) varies among community-dwelling patients and this difference partly depends on the methods used to evaluate improper use. OBJECTIVE: The aim of our study was to assess the prevalence and type of PIP among community-dwelling elderly as well as among middle-aged people by applying three different explicit tools - Ghent Older People's Prescriptions community Pharmacy Screening (GheOP3S) tool, The European Union Potentially Inappropriate Medications EU(7)-PIM list and PRescribing Optimally in Middle-aged People's Treatments (PROMPT). METHODS: Cross-sectional study among community-dwelling patients in Tirana (Albania) from 1 March to 1 June 2018. Two community pharmacists reviewed the prescriptions independently. The PIP index and the mean number of PIP / patient was calculated. RESULTS: In total, 241 participants were included in the study. Among 142 elderly patients, 55.6 % and 54.2 % of them were prescribed at least one PIP, respectively according to the GheOP3S tool and the EU7 PIM list. After applying PROMPT criteria, we found at least one PIP in 33.3 % of the middle-aged patients. The most commonly represented PIP drugs groups were cardiovascular drugs among older people and non-steroidal anti-inflammatory drugs among middle-aged people. Reminding and proposing the patient to undergo yearly influenza vaccination was the most common potentially prescribing omission. CONCLUSIONS: Prevalence of PIP is higher in elderly patients and slightly different according to the tool used for detection. However, PIP are also common in the middle-aged population.