Treatment strategies for isolated systolic hypertension in elderly patients

Hypertension in an ageing population: Diagnosis, mechanisms, collateral health risks, treatments, and clinical challenges

Ageing population is considerably increasing worldwide, which is considered to reflect an improved quality of life. However, longevity in the human lifespan has increased the burden of late-life illnesses including cancer, neurodegeneration, and cardiovascular dysfunction. Of these, hypertension is the most common condition with huge health risks, with an increased prevalence among the elderly. In this review, we outline the current guidelines for defining hypertension and examine the detailed mechanisms underlying the relationship between hypertension and ageing-related outcomes, including sodium sensitivity, arterial stiffness, endothelial dysfunction, isolated systolic hypertension, white coat effect, and orthostatic hypertension. As hypertension-related collateral health risk increases among the elderly, the available management strategies are necessary to overcome the clinical treatment challenges faced among elderly population. To improve longevity and reduce adverse health effects, potential approaches producing crucial information into new era of medicine should be considered in the prevention and treatment of hypertension among elderly population. This review provides an overview of mechanisms underlying hypertension and its related collateral health risk in elderly population, along with multiple approaches and management strategies to improve the clinical challenges among elderly population.

Prevalence of elevated blood pressure among locomotive workers according to the long-term assessment of pre-trip health screening

Hypertension is considered as one of the leading cardiovascular diseases in transport workers.

Aim. In the context of epidemiological prospective study, to assess the prevalence of elevated blood pressure (BP) detected at pre-trip health screening (PTHS).

Material and methods. We analyzed records of the database of PTHS automatic system for 15 years (2006-2020) to reveal elevated systolic (140 mm Hg) and/or diastolic (90 mm Hg) BP.

Results. For 15 years, the detection rate of systolic BP >140 mm Hg has decreased by 4 times. For diastolic BP, the detection rate of values >90 mm Hg decreased by 8 times. The detection rate of non-normal systolic BP among railway staff correlates with the detection rate of non-normal diastolic BP (r=0,92; p<0,05) on different railways. Over the 15-year period, the number of suspensions from the trip due to PTHS has decreased by 2 times, while the number of suspensions due to hypertension decreased by 2,5 times.

Conclusion. The conducted study may indicate the effectiveness of primary and secondary prevention of hypertension among Russian Railways staff.

Potential role of Drug Repositioning Strategy (DRS) for management of tauopathy

Tauopathy is a term that has been used to represent a pathological condition in which hyperphosphorylated tau protein aggregates in neurons and glia which results in neurodegeneration, synapse loss and dysfunction and cognitive impairments. Recently, drug repositioning strategy (DRS) becomes a promising field and an alternative approach to advancing new treatments from actually developed and FDA approved drugs for an indication other than the indication it was originally intended for. This paradigm provides an advantage because the safety of the candidate compound has already been established, which abolishes the need for further preclinical safety testing and thus substantially reduces the time and cost involved in progressing of clinical trials. In the present review, we focused on correlation between tauopathy and common diseases as type 2 diabetes mellitus and the global virus COVID-19 and how tau pathology can aggravate development of these diseases in addition to how these diseases can be a risk factor for development of tauopathy. Moreover, correlation between COVID-19 and type 2 diabetes mellitus was also discussed. Therefore, repositioning of a drug in the daily clinical practice of patients to manage or prevent two or more diseases at the same time with lower side effects and drug-drug interactions is a promising idea. This review concluded the results of pre-clinical and clinical studies applied on antidiabetics, COVID-19 medications, antihypertensives, antidepressants and cholesterol lowering drugs for possible drug repositioning for management of tauopathy.