Blood pressure management in hypertensive patients with syncope: how to balance hypotensive and cardiovascular risk

Giulia Rivasi, Michele Brignole, Martina Rafanelli, Grzegorz Bilo, Martino F. Pengo, Andrea Ungar, Gianfranco Parati

Research output: Contribution to journalArticlepeer-review

Abstract

: Managing hypertension in syncope patients requires the accurate balancing of hypotensive and cardiovascular risks. On the basis of the available literature, this study analyses the complex inter-relationship between these clinical problems and presents an algorithm strategy to guide hypertension management in patients affected by syncope episodes. A SBP target of 120 mmHg is recommended in patients with a low syncope risk and a high cardiovascular risk. In patients with a high syncope risk and a low cardiovascular risk, and in older (70+) frail individuals, a less intensive treatment is advisable, targeting SBP of 140 mmHg. SBP values up to 160 mmHg can be tolerated in severe frailty or disability.Patients with hypertension and syncope may benefit from team-based care by a 'Blood Pressure Team' including experts on hypertension and syncope and a geriatrician. The team should carry out a multidimensional assessment to balance syncope and cardiovascular risk and develop therapeutic strategies customized to individuals' frailty and functional status.

Original languageEnglish
Pages (from-to)2356-2362
Number of pages7
JournalJournal of Hypertension
Volume38
Issue number12
DOIs
Publication statusPublished - Dec 1 2020

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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