Dalbavancin as sequential therapy in infective endocarditis: Real-life experience in elder and comorbid patients.

OBJECTIVES: This study aimed to evaluate the effectiveness of dalbavancin as sequential therapy in patients with infective endocarditis (IE) due to gram positive bacteria (GPB) in a real-life heterogenous cohort with comorbid patients. METHODS: A single center retrospective cohort study including all patients with definite IE treated with dalbavancin between January 2017 and February 2022 was developed. A 6-month follow-up was performed. The main outcomes were clinical cure rate, clinical and microbiological relapse, 6-month mortality, and adverse effects (AEs) rate. RESULTS: The study included 61 IE episodes. The median age was 78.5 years (interquartile range [IQR] 63.2-85.2), 78.7% were male, with a median Charlson comorbidity index of 7 (IQR 4-9) points. Overall, 49.2% suffered native valve IE. The most common microorganism was Staphylococcus aureus (26.3%) followed by Enterococcus faecalis (21.3%). The median duration of initial antimicrobial therapy and dalbavancin therapy were 27 (IQR 20-34) and 14 days (IQR 14-28) respectively. The total reduction of hospitalization was 1090 days. The most frequent dosage was 1500mg of dalbavancin every 14 days (96.7%). An AE was detected in 8.2% of patients, only one (1.6%) was attributed to dalbavancin (infusion reaction). Clinical cure was achieved in 86.9% of patients. One patient (1.6%) with Enterococcus faecalis IE suffered relapse. The 6-month mortality was 11.5%, with only one IE-related death (1.6%). CONCLUSION: This study shows a high efficacy of dalbavancin in a heterogeneous real-world cohort of IE patients, with an excellent safety profile. Dalbavancin allowed a substantial reduction of in-hospital length of stay.

Privacidade e confidencialidade dos dados de pessoas idosas frente às tecnologias de monitoramento em saúde / Privacidad y confidencialidad de los datos de las personas mayores frente a las tecnologías de vigilancia de la salud / Privacitat i confidencialitat de les dades de las persones grans davant les tecnologies de vigilància de la salut / Privacy and data confidentiality of older people in the face of health monitoring technologies

O presente artigo discute os avanços e desafios das tecnologias de monitoramento em saúde de pessoas idosas e suas implicações na privacidade e confidencialidade dos dados coletados. Trata-se de estudo exploratório, fundamentado na literatura, com síntese narrativa. O texto contextualiza as demandas decorrentes do envelhecimento populacional e o uso de sensores e de outros dispositivos eletrônicos no monitoramento de atividades diárias de pessoas idosas em ambientes internos e externos. É importante ressaltar que os benefícios oferecidos pelas tecnologias não devem comprometer a privacidade e a confidencialidade dos dados. Para garantir isso, é necessário aprimorar os mecanismos regulatórios, estabelecendo padrões de segurança e princípios éticos para a proteção de dados pessoais, respeitando a privacidade e a confidencialidade dos dados.(AU)

L'article present discuteix els avenços i reptes de les tecnologies de monitoratge en salut de les persones majors i les seves implicacions en la privacitat i confidencialitat de les dades recopilades. Es tracta d'un estudi exploratori, fonamentat en la literatura, amb una síntesi narrativa. El text contextualitza les demandes derivades de l'envelliment de la població i l'ús de sensors i d'altres dispositius electrònics en el monitoratge de les activitats quotidianes de les persones majors en ambients interns i externs. És important destacar que els beneficis oferts per les tecnologies no han de comprometre la privacitat i la confidencialitat de les dades. Per garantir-ho, és necessari millorar els mecanismes reguladors, establint estàndards de seguretat i principis ètics pera la protecció de dades personals, respectant la privacitat i la confidencialitat de les dades.(AU)

El presente artículo discute los avances y desafíos de las tecnologías de monitorización en salud de personas mayores y sus implicaciones en la privacidad y confidencialidad de los datos recolectados. Se trata de un estudio exploratorio, fundamentado en la literatura, con síntesis narrativa. El texto contextualiza las demandas derivadas del envejecimiento poblacional y el uso de sensores y otros dispositivos electrónicos en la monitorización de actividades diarias de personas mayores en ambientes internos y externos. Es importante resaltar que los beneficios ofrecidos por las tecnologías no deben comprometer la privacidad y confidencialidad de los datos. Para garantizar esto, es necesario mejorar los mecanismos reguladores, estableciendo estándares de seguridad y principios éticos para la protección de datos personales, respetando la privacidad y confidencialidad de los dato.(AU)

This article discusses the advances and challenges of health monitoring technologies for elderly individuals and their implications on the privacy and confidentiality of collected data. It is an exploratory study grounded in the literature, with a narrative synthesis. The text contextualizes the demands arising from the aging population and the use of sensors and other electronic devices in monitoring daily activities of elderly people in both indoor and outdoor environments. It is important to emphasize that the benefits offered by these technologies should not compromise the privacy and confidentiality of the data. To ensure this, it is necessary to enhance regulatory mechanisms by establishing security standards and ethical principles for the protection of personal data, while respecting privacy and data confidentiality.(AU)

Insuficiencia cardiaca en octogenarios con fibrilación auricular: incidencia y factores de riesgo / Heart failure in older patients with atrial fibrillation: incidence and risk factors

Introducción y objetivos: La fibrilación auricular (FA) está interconectada con la insuficiencia cardiaca (IC). Sin embargo, los factores que pueden precipitar la aparición de IC en los pacientes con FA están escasamente descritos. Con este estudio, se pretende determinar la incidencia, los predictores y el pronóstico de la IC de nueva aparición en una población de pacientes ancianos con FA sin antecedentes de IC.MétodosPacientes con FA mayores de 80 años, sin antecedente de IC, identificados entre los años 2014 y 2018.ResultadosDurante 3,7 años, se siguió a 5.794 pacientes (edad, 85,2±3,8 años; el 63,2% mujeres). En el 33,3% de los casos (tasa de incidencia, 11,5/100 pacientes-año) apareció IC de novo, mayoritariamente con fracción de eyección del ventrículo izquierdo conservada. A partir de un análisis multivariante, se identificaron 11 factores de riesgo de aparición de la IC independientemente de su subtipo: enfermedad valvular significativa (HR=1,99; IC95%, 1,73-2,28), fracción de eyección del ventrículo izquierdo reducida (HR=1,92; IC95%, 1,68-2,19), enfermedad pulmonar obstructiva crónica (HR=1,59; IC95%, 1,40-1,82), aumento de la aurícula izquierda (HR=1,47; IC95%, 1,33-1,62), enfermedad renal (HR=1,36; IC95%, 1,24-1,49), desnutrición (HR=1,33; IC95%, 1,21-1,46), anemia (HR=1,30; IC95%, 1,17-1,44), FA permanente (HR=1,15; IC95%, 1,03-1,28), diabetes mellitus (HR=1,13; IC95%, 1,01-1,27), por cada año de aumento de la edad (HR=1,04; IC95%, 1,02-1,05) y por cada kg/m2 del índice de masa corporal (HR=1,03; IC95%, 1,02-1,04). La presencia de IC prácticamente duplicó la mortalidad (HR=1,67; IC95%, 1,53-1,81).ConclusionesLa IC de nueva aparición en ancianos con FA fue muy frecuente y prácticamente duplicó la mortalidad. Se identificaron 11 factores de riesgo, lo cual amplía el ámbito de prevención primaria en esta entidad. (AU)

Introduction and objectives: Atrial fibrillation (AF) is linked to heart failure (HF). However, little has been published on the factors that may precipitate the onset of HF in AF patients. We aimed to determine the incidence, predictors, and prognosis of incident HF in older patients with AF with no prior history of HF.MethodsPatients with AF older than 80 years and without prior HF were identified between 2014 and 2018.ResultsA total of 5794 patients (mean age, 85.2±3.8 years; 63.2% women) were followed up for 3.7 years. Incident HF, predominantly with preserved left ventricular ejection fraction, developed in 33.3% (incidence rate, 11.5-100 people-year). Multivariate analysis identified 11 clinical risk factors for incident HF, irrespective of HF subtype: significant valvular heart disease (HR, 1.99; 95%CI, 1.73-2.28), reduced baseline left ventricular ejection fraction (HR, 1.92; 95%CI, 1.68-2.19), chronic pulmonary obstructive disease (HR, 1.59; 95%CI, 1.40-1.82), enlarged left atrium (HR 1.47, 95%CI 1.33-1.62), renal dysfunction (HR 1.36, 95%CI 1.24-1.49), malnutrition (HR, 1.33; 95%CI, 1.21-1.46), anemia (HR, 1.30; 95%CI, 1.17-1.44), permanent AF (HR, 1.15; 95%CI, 1.03-1.28), diabetes mellitus (HR, 1.13; 95%CI, 1.01-1.27), age per year (HR, 1.04; 95%CI, 1.02-1.05), and high body mass index for each kg/m2 (HR, 1.03; 95%CI, 1.02-1.04). The presence of incident HF nearly doubled the mortality risk (HR, 1.67; 95%CI, 1.53-1.81).ConclusionsThe presence of HF in this cohort was relatively frequent and nearly doubled the mortality risk. Eleven risk factors for HF were identified, expanding the scope for primary prevention among elderly patients with AF. (AU)

Heart failure in older patients with atrial fibrillation: incidence and risk factors.

INTRODUCTION AND OBJECTIVES: Atrial fibrillation (AF) is linked to heart failure (HF). However, little has been published on the factors that may precipitate the onset of HF in AF patients. We aimed to determine the incidence, predictors, and prognosis of incident HF in older patients with AF with no prior history of HF. METHODS: Patients with AF older than 80 years and without prior HF were identified between 2014 and 2018. RESULTS: A total of 5794 patients (mean age, 85.2±3.8 years; 63.2% women) were followed up for 3.7 years. Incident HF, predominantly with preserved left ventricular ejection fraction, developed in 33.3% (incidence rate, 11.5-100 people-year). Multivariate analysis identified 11 clinical risk factors for incident HF, irrespective of HF subtype: significant valvular heart disease (HR, 1.99; 95%CI, 1.73-2.28), reduced baseline left ventricular ejection fraction (HR, 1.92; 95%CI, 1.68-2.19), chronic pulmonary obstructive disease (HR, 1.59; 95%CI, 1.40-1.82), enlarged left atrium (HR 1.47, 95%CI 1.33-1.62), renal dysfunction (HR 1.36, 95%CI 1.24-1.49), malnutrition (HR, 1.33; 95%CI, 1.21-1.46), anemia (HR, 1.30; 95%CI, 1.17-1.44), permanent AF (HR, 1.15; 95%CI, 1.03-1.28), diabetes mellitus (HR, 1.13; 95%CI, 1.01-1.27), age per year (HR, 1.04; 95%CI, 1.02-1.05), and high body mass index for each kg/m2 (HR, 1.03; 95%CI, 1.02-1.04). The presence of incident HF nearly doubled the mortality risk (HR, 1.67; 95%CI, 1.53-1.81). CONCLUSIONS: The presence of HF in this cohort was relatively frequent and nearly doubled the mortality risk. Eleven risk factors for HF were identified, expanding the scope for primary prevention among elderly patients with AF.

Frailty assessment has come to stay: Retrospective analysis pilot study of two frailty scales in oncological older patients undergoing colorectal surgery.

INTRODUCTION: Colorectal cancer is a disease of the elderly and its main treatment is surgery. Frailty, a clinical syndrome of decreased reserve, increases with age and has been recognized as a predictive factor for postoperative mortality. Our primary objective was to assess the association between two frailty scores and mortality within the first year after surgery, by retrospectively linking frailty scores to mortality data and comparing the strength of their association with mortality to that of the ASA Classification. The frailty scales used were: the Modified Frailty Index (MFI) and, the Risk Analysis Index-A (RAI-A) and the G8 screening test (G8). As secondary objectives, we assessed the relationship of the frailty scales with morbidity and compared all the scales with the ASA. MATERIAL AND METHODS: We retrospectively studied 172 patients aged 65 years and older who underwent laparoscopic colorectal surgery for cancer between January 2017 and June 2018, following them up for 1year after surgery. RESULTS: Both morbidity and mortality were significantly associated with all frailty scale scores (p<.001). The more frailty, the greater probability of prolonged hospital stay, complications, readmissions and emergency department visits. Using each scale, patients were categorized into two groups (frail and non-frail patients). The C-indexes for 1-year mortality with the RAI-A and, MFI and G8 were 0.89 and, 0.86 and 0.86 respectively. On the other hand, ASA status is not strongly associated with mortality, with a C-index of .63. DISCUSSION: Frailty scores should begin to influence medical and surgical strategies and further research is needed to develop guidelines for interventions in geriatric patients.

La evaluación de la fragilidad ha venido para quedarse: Estudio piloto retrospectivo de dos escalas de fragilidad en ancianos oncológicos intervenidos de cirugía colorrectal / Frailty assessment has come to stay: Retrospective analysis pilot study of two frailty scales in oncological older patients undergoing colorectal surgery

Introducción: El cáncer colorrectal es una enfermedad que habitualmente aparece en ancianos y su principal tratamiento continúa siendo quirúrgico. La fragilidad es síndrome clínico que se caracteriza por presentar una disminución de la reserva fisiológica, aumenta con la edad y ha sido reconocido como un factor predictivo de mortalidad postoperatoria. Nuestro objetivo primario ha sido evaluar la asociación entre dos escalas de fragilidad y la mortalidad a un año después de la cirugía, y comparando la fuerza de su asociación del poder predictivo de mortalidad de las escalas de fragilidad y la de la clasificación de la American Society of Anesthesiologists (ASA). Las escalas utilizadas fueron: Modified Frailty Index (MFI) y el Risk Analysis Index (RAI-A). Los objetivos secundarios han sido la evaluación de la relación de las escalas de fragilidad con la morbilidad y la comparación de estas con la clasificación ASA en cuanto a predicción de morbilidad. Material y métodos: Analizamos retrospectivamente 172 pacientes mayores de 65 años que fueron intervenidos de cirugía oncológica colorrectal laparoscópica desde enero de 2017 hasta junio de 2018 con un seguimiento de un año posterior a la cirugía. Resultados: La fragilidad esta significativamente asociada a la mortalidad y morbilidad (p < 0,001). A más fragilidad, mayor probabilidad de estancia hospitalaria, complicaciones, reingresos y visitas a urgencias. Los pacientes fueron categorizados en dos grupos (pacientes frágiles y no frágiles). Los C-index de la predicción a mortalidad a un año obtenidos con el RAI-A y el MFI fueron 0,89 y 0,86, respectivamente. Por otro lado, la clasificación ASA no se relaciona con mortalidad, su C-index fue del 0,63. Discusión: Las escalas de fragilidad deberían empezar a influenciar las intervenciones médicas y quirúrgicas, y se deberían implementar guías y protocolos que tuviesen en cuenta el grado de fragilidad de los pacientes geriátricos.(AU)

Introduction: Colorectal cancer is a disease of the elderly and its main treatment is surgery. Frailty, a clinical syndrome of decreased reserve, increases with age and has been recognized as a predictive factor for postoperative mortality. Our primary objective was to assess the association between twohree frailty scores and mortality. within the first year after surgery, by retrospectively linking frailty scores to mortality data and comparing the strength of their association with mortality to that of the ASA Classification. The frailty scales used were: the Modified Frailty Index (MFI) and, the Risk Analysis Index-A (RAI-A) and the G8 screening test (G8). As secondary objectives, we assessed the relationship of the frailty scales with morbidity and compared all the scales with the ASA. Material and methods: We retrospectively studied 172 patients aged 65 years. and older who underwent laparoscopic colorectal surgery for cancer between January 2017 and June 2018, following them up for 1 year after surgery. Results: Both morbidity and mortality were significantly associated with all frailty scale scores (p < 0.001). The more frailty, the greater probability of prolonged hospital stay, complications, readmissions and emergency department visits. Using each scale, patients were categorized into two groups (frail and non-frail patients). The C-indexes for 1-year mortality with the RAI-A and, MFI and G8 were 0.89 and, 0.86 and 0.86 respectively. On the other hand, ASA status is not strongly associated with mortality, with a C-index of 0.63. Discussion: Frailty scores should begin to influence medical and surgical strategies and further research is needed to develop guidelines for interventions in geriatric patients.(AU)

Mortalidad, riesgo cardiovascular y estado de salud actual de una cohorte de varones iniciada en el año 1968. Estudio Manresa / Mortality, cardiovascular risk, and health status in a male cohort initiated in 1968. The Manresa study

Objetivos: Analizar la mortalidad y sus causas en la cohorte Manresa de varones seguida durante 42 años; comparar el riesgo de mortalidad cardiovascular al inicio del seguimiento con la mortalidad acontecida; describir el estado de salud de los participantes al final del estudio. Métodos: Estudio observacional prospectivo. Se calculó la incidencia de mortalidad acumulada de la cohorte. La asociación de los factores de riesgo cardiovasculares (FRCV) con la mortalidad fue calculada mediante análisis de regresión logística de efectos mixtos. Se evaluó la curva ROC comparando cada ecuación predictiva con la mortalidad real. Se llevó a cabo un análisis descriptivo del estado de salud en la última encuesta del estudio. Resultados: Las defunciones fueron 457 (43%). La incidencia acumulada fue del 10,6% para las enfermedades cardiovasculares. Los factores de riesgo cardiovasculares asociados significativamente a la mortalidad cardiovascular fueron: edad, colesterol y tabaquismo. El uso de tablas para el cálculo del riesgo cardiovascular resultó ser útil, con pocas diferencias según la tabla utilizada. Entre los factores de riesgo cardiovasculares analizados en el último examen de salud, y por tanto en una población anciana, destacan la alta prevalencia de hipertensión y de actividad física regular, junto con la baja prevalencia en tabaquismo. Conclusión: La mortalidad cardiovascular se mantuvo alta, aunque ha pasado a ser la segunda causa tras las enfermedades tumorales. Se compararon en nuestro medio las predicciones de las tablas de riesgo de mortalidad cardiovascular con la mortalidad real durante más de 4 décadas, mostrándose la importancia de estimar el riesgo cardiovascular en la población adulta.(AU)

Objectives: To analyse mortality and its causes in the Manresa male cohort followed over 42 years; to compare the initial risk of cardiovascular mortality with actual mortality; and to describe the health status of the participants at the end of the study. Methods: Prospective observational study, in which an analysis of the cumulative incidence of mortality was performed. The association of cardiovascular risk factors with mortality was calculated with a logistic regression analysis of mixed effect. The risk of mortality of individuals was evaluated and compared with true cardiovascular mortality using ROC curves. At the end of the study, a descriptive analysis of CVRF and health status of participants in the last survey was performed. Results: The number of deaths was 457 (43%). Cumulative incidence for cardiovascular diseases was 10.6%. Cardiovascular risk factors significantly associated with cardiovascular mortality were age, cholesterol, and smoking. The use of risk score charts for cardiovascular mortality was found to be useful, and there were no differences between tables. In the last health screening of cardiovascular risk factors levels in an elderly population, a high prevalence was found of hypertension and of regular physical activity, together with a low prevalence of smoking. Conclusions: Cardiovascular mortality remained high, although it has become the second cause after tumoural diseases. The comparison of predictions from cardiovascular mortality risk tables with actual mortality rates in our area over more than 4 decades demonstrated the importance of assessing cardiovascular risk in the adult population.(AU)

[Mortality, cardiovascular risk, and health status in a male cohort initiated in 1968. The Manresa study]. / Mortalidad, riesgo cardiovascular y estado de salud actual de una cohorte de varones iniciada en el año 1968. Estudio Manresa.

OBJECTIVES: To analyse mortality and its causes in the Manresa male cohort followed over 42 years; to compare the initial risk of cardiovascular mortality with actual mortality; and to describe the health status of the participants at the end of the study. METHODS: Prospective observational study, in which an analysis of the cumulative incidence of mortality was performed. The association of cardiovascular risk factors with mortality was calculated with a logistic regression analysis of mixed effect. The risk of mortality of individuals was evaluated and compared with true cardiovascular mortality using ROC curves. At the end of the study, a descriptive analysis of CVRF and health status of participants in the last survey was performed. RESULTS: The number of deaths was 457 (43%). Cumulative incidence for cardiovascular diseases was 10.6%. Cardiovascular risk factors significantly associated with cardiovascular mortality were age, cholesterol, and smoking. The use of risk score charts for cardiovascular mortality was found to be useful, and there were no differences between tables. In the last health screening of cardiovascular risk factors levels in an elderly population, a high prevalence was found of hypertension and of regular physical activity, together with a low prevalence of smoking. CONCLUSIONS: Cardiovascular mortality remained high, although it has become the second cause after tumoural diseases. The comparison of predictions from cardiovascular mortality risk tables with actual mortality rates in our area over more than 4 decades demonstrated the importance of assessing cardiovascular risk in the adult population.

[Usefulness of the summary of product characteristics as a tool to improve prescription in elderly patients]. / Utilidad de la ficha técnica de los medicamentos como herramienta para mejorar la prescripción en pacientes mayores.

BACKGROUND AND OBJECTIVE: The Drug Technical Data Sheet should contribute to a safe and effective use of medications in the elderly, providing accurate information on the prescription, on the possible benefits or risks of the medications, or failing that, communicating the lack of information on their use in this group. The aim of this article was to quantify the specific information for people over 65 years of age included in the data sheets of the drugs available in Spain, and enables an adequate prescription in this population. MATERIALS AND METHODS: A multidisciplinary group reviewed all the Technical Data Sheets of drugs approved by the Spanish Agency for Medicines and Health Devices (AEMPS). The quality of the information was classified into 4 categories: information specifically referring to the population over 65 years old; information specifically referring to the population over 80 years old; recommendations not specific to the elderly; and specific information for the elderly. RESULTS: A total of 1,462 Technical Sheets were reviewed, of which 48% had information regarding prescription in the elderly. Information on the use in patients over 80 years old was present in 1.23% of the sheets. Only 6.83% of all the sheets reviewed included specific recommendations for the elderly. CONCLUSIONS: There is little specific information regarding prescription in the elderly in the technical data sheets of drugs prescribed/sold in Spain. To improve knowledge in this field, data must be provided in the sheets that are based on the scientific literature, clinical trials for the elderly, or pharmacovigilance studies focused on this population.

[Profiles of loneliness and social isolation in urban population]. / Perfiles de soledad y aislamiento social en población urbana.

OBJECTIVE: To assess the prevalence of loneliness and social isolation in a population over 65 cared by a urban primary health team and to identify its main characteristics. DESIGN: Cross-sectional descriptive study by a telephone survey. SETTING: Basic health area of Barcelona. PARTICIPANTS: Random sample of assigned population of 65 or more years old. MAIN MEASUREMENTS: UCLA Loneliness Scale and Lubben Social Network Scale. RESULTS: 278 persons were interviewed (61,36% response rate), 172 women and 106 men, with an average age of 76,7 ± 7,9 years. A higher proportion of factors related to loneliness were identified in non-respondents. Loneliness was closely correlated to social r = 0,736. Moderate loneliness, with a prevalence of 16,54%, was associated to walking difficulties (OR 3,09, 95%, IC 1,03-9,29), cognitive impairment (OR 3,97, 95% IC 1,19-13,27) and architectural barriers (OR 5.29, 95% IC 2.12-13,23), although severe loneliness, with a prevalence of 18,71% was only associated to living together with less people (OR 0.61, 95% IC 0.40-0.93). Social isolation, with a prevalence of 38,85% was associated to aging (OR 1,06, 95% IC 1,02-1,10) and to the belief of having health problems (OR 4,35, 95% IC 1,11-16,99). CONCLUSIONS: Loneliness and social isolation are of high prevalence. The telephone survey underestimates its prevalence. There are 2profiles of loneliness, one with moderate associated to the socialisation difficulties related to aging and another severe not related to health or to barriers that only can be identified by surveys or clinical interview. Interventions must be targeted to each of these profiles.

Perfil socio-sanitário de idosos da estratégia saúde da família: estudo descritivo / Socio-sanitary profile of the elderly in the family health strategy: a descriptive study / Perfil socio-sanitario de los ancianos en la estrategia de salud familiar: estudio descriptivo

OBJETIVO: avaliar as condições de vida e saúde de idosos assistidos por equipes da Estratégia de Saúde da Família de um município, na região Amazônica. MÉTODO: estudo descritivo, transversal realizado com 441 idosos selecionados por amostra não probabilística no município de Benevides, Brasil. Aplicou-se a Caderneta dos Idosos para atribuição do perfil dos usuários idosos. RESULTADOS: constatou-se no perfil, idosos predominantemente jovens (46%), com baixa escolaridade (86%), sedentários (84%), com afecções crônicas (82%), com estado regular (55%) de saúde auto referido, procuram unidade de saúde apenas para adquirir medicamentos (58%). DISCUSSÃO: Os dados mostraram necessidade de adotar ações de promoção do envelhecimento saudável baseadas na integralidade da assistência. CONCLUSÃO: a inferência dos resultados obtidos à população idosa do município estudado impõe desafios na efetivação do acolhimento dos usuários idosos baseado nas reais necessidades dessa população, com foco primordial da enfermagem na Atenção Básica em contextos semelhantes, mais carentes, da região amazônica.

OBJECTIVE: To evaluate the living and health conditions of the elderly attended by Family Health Strategy teams of a municipality in the Amazon region. METHOD: a descriptive cross-sectional study conducted with 441 elderly selected by non-probabilistic sample in the city of Benevides, Brazil. The Elderly Handbook was applied to assign the profile of the elderly users. RESULTS: predominantly young elderly (46%), with low education (86%), sedentary (84%), with chronic conditions (82%), with a normal self-reported health status (55%), who only seek health clinics to purchase medicines (58%) were found in the profile. DISCUSSION: The data showed the need to adopt actions to promote healthy aging based on comprehensive care. CONCLUSION: the inference of the results obtained for the elderly population of the studied municipality promotes the realization of the reception of elderly users based on the real needs of this population, with focus on nursing in Primary Health Care in similar, needier contexts, of the Amazon region.

OBJETIVO: Evaluar las condiciones de vida y salud de las personas mayores con la asistencia de equipos de Estrategia de Salud Familiar de un municipio de la región amazónica. MÉTODO: estudio descriptivo, transversal con 441 adultos mayores seleccionados por muestra no probabilística en la ciudad de Benevides, Brasil. La libreta de personas mayores se aplicó para asignar el perfil de los usuarios. RESULTADOS: se encontró en el perfil, predominantemente jóvenes de edad avanzada (46%), con baja educación (86%), sedentarios (84%), con afecciones crónicas (82%), con estado de salud regular autoinformado (55%), buscar unidad de salud solo para comprar medicamentos (58%). DISCUSIÓN: Los datos mostraron la necesidad de adoptar acciones para promover el envejecimiento saludable basado en la atención integral. CONCLUSIÓN: la inferencia de los resultados obtenidos a la población anciana del municipio estudiado impone desafíos en la realización de la recepción de usuarios ancianos en función de las necesidades reales de esta población, con enfoque primario de enfermería en Atención Primaria en contextos similares y más necesitados, de la región amazónica.

[Approach to hypertension in the older population]. / Abordaje de la hipertensión arterial en el paciente anciano.

Hypertension is one of the most frequent causes for seeking primary care attention and its prevalence increases with age, affecting 68% of people older than 60 years. Data indicate that the prevalence of hypertense individuals older than 65 years has increased from 48% in 2002 to 58% in 2010. High blood pressure is related to 1 out of every 2 deaths from cardiovascular causes in the Spanish population ≥ 50 years and causes 13.5% of premature deaths worldwide, both in persons with hypertension and in those with high-normal blood pressure. Although few clinical trials have been performed in the older population, especially in the very old, there is evidence that diastolic and systolic blood pressure control reduces cardiovascular morbidity and mortality in older hypertense individuals. Consequently, the updates of the various clinical practice guidelines continue to include among their objectives-with some nuances-good blood pressure control in this population group. The present article reviews new evidence on the approach to hypertension in the elderly, which has modified some of the recommendations made in the clinical practice guidelines of several scientific societies.