ReviewDrugs & aging1996
Optimal dosage of ACE inhibitors in older patients.
Review in Drugs & aging, 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 14 citations in OpenAlex.
- The Blood Pressure "Uncertainty Range" - a pragmatic approach to overcome current diagnostic uncertainties (II).Current controlled trials in cardiovascular medicine · 2005Article
- Beyond the Evidence of the New Hypertension Guidelines. Blood pressure measurement - is it good enough for accurate diagnosis of hypertension? Time might be in, for a paradigm shift (I).Current controlled trials in cardiovascular medicine · 2005Article
- [Cardiovascular pharmacotherapy in the aged].Der Internist · 2003Review
- Cardiovascular drug therapy in the elderly: theoretical and practical considerations.Drugs & aging · 2003Review
- A survey of the dose of ACE inhibitors prescribed by general physicians for patients with heart failure.Postgraduate medical journal · 2001Article
- Drug selection for optimal treatment of hypertension in the elderly.Drugs & aging · 1997Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite having lower levels of plasma renin activity than younger individuals, elderly patients with hypertension respond well to ACE inhibitors and the drugs have few adverse effects. Plasma concentrations of the active ACE inhibitor are generally higher in the elderly because of decreased renal clearance. These altered pharmacokinetics, combined with impairment of cardiovascular reflexes and the increasing prevalence of heart failure and renal impairment with age, render elderly patients more susceptible to first-dose hypotension. Although many studies have shown that standard dosages are well tolerated it is safer to use lower initial dosages of ACE inhibitors in elderly hypertensive patients because hypotensive reactions are not always predictable. The maintenance dosage may be determined more by the presence of renal disease or heart failure than by age per se. In elderly patients with heart failure, ACE inhibitors should be introduced even more cautiously, using low dosages and preferably under supervision. It may also be necessary to interrupt diuretic treatment for a few days to prevent severe hypotension. The ACE inhibitor dosage should then be titrated up to the maximum that is well tolerated, as this appears to offer the greatest benefit.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.