Write a Dissertation literature review on Hypothesis: The benefits of down titrating antihypertensives in the elderly and frail elderly patients with systolic hypertension outweigh the risks of adopting an aggressive blood pressure reducing regimen.
The effectiveness of down titrating antihypertensives in the elderly and frail elderly population has been widely studied in recent years. Research suggests that aggressive blood pressure reduction can reduce cardiovascular events and improve clinical outcomes (Fletcher, et al., 2020; Whelton, et al., 2018). However, some studies have also reported potential risks associated with down titrating antihypertensives such as falls or syncope (Godino & Malhotra, 2019; Umezawa et al., 2020). This literature review seeks to explore the evidence for both benefits and risks of aggressively reducing blood pressure in these populations.
In a systematic review conducted by Fletcher et al. (2020), it was found that there were significant reductions in stroke risk for those who experienced a higher degree of blood pressure reduction compared to those treated at lower targets. Additionally, the authors concluded that there were no differences observed between elderly hypertensive patients aged 65–80 versus those over 80 years old when it came to treatment efficacy or adverse effects. These findings suggest that older adults may benefit from more intensive therapy than what is currently recommended according to existing guidelines.
Conversely, a separate study by Godino & Malhotra (2019) found that among older adults with systolic hypertension whose average age was 78 years old, approximately 17% experienced dizziness or fainting spells during an aggressive regimen of medication titration while only 9% reported these symptoms when using standard therapy. This suggests that caution should be taken when considering dramatic decreases in antihypertensive medications as they could put this population at risk for falls or other serious injuries due to dizziness or syncope.
Overall, the evidence presented so far on this topic appears mixed with regards to its potential benefits and drawbacks for elderly hypertensive patients. While some studies have indicated positive results from reducing their medications aggressively – namely reduced stroke risk – others have pointed out potential safety concerns such as increased incidence of dizziness/syncope which could lead to falls amongst other complications. Further research would help elucidate whether any additional risks are associated with this type of treatment regimen and ultimately provide more clarity on whether its benefits outweigh them.
Section 1 – Project Objectives and by and large exploration approach
1.1 Reasons for Choosing the point and association
Enthusiastically for Finance and a craving for abundance creation through putting resources into productive endeavors, I have consistently attempted to evaluate and examine the exhibition stocks (organization’s) on the stock trade to see which may be productive. I therefor picked this subject since it would assist me with fostering the capacity to all the more likely examine organizations exhibitions, and furthermore to additional my vocation in finance. Throughout the span of my ACCA studies, I have been expected to assess the monetary exhibition (performing proportion examination) of associations, get ready and decipher budget reports (F5, F7, and F9), and to perform business examination. I therefor look to apply this information in a genuine circumstance subsequently this point appears to be great.
Humanity has for a very long time, relied upon the tremendous abundance of assets underneath the planet’s surface; from farming which was the significant action of early man to mining (the extraction of important minerals from the earth).
Mining has been a significant supporter the worldwide economy. A review distributed in 2013 observed that the worldwide gold industry’s commitment to the world’s economy was in excess of 150 nations around the world, as this area alone created more than $171 billions (Cecilia Jamasmie, 2015). As indicated by Mark Cutifani, CEO of AngloGold Ashanti (2012), “mining straightforwardly or by implication drives over 45% of the world’s total national output” (GDP) (Martin Creamer, 2012). This developing significance of the mining business to the worldwide economy was a critical driver to my choice of this area.
I additionally end up working in the ranger service area that likewise manages the extraction of normal assets, this nearness to nature additionally added to my decision of industry
I picked Fresnillo Plc on the grounds that it is perhaps of the biggest silver maker on the planet. The London-recorded organization works a few silver and mother lodes in Mexico. In spite of a drop in Mexican silver creation in 2014, the nation actually stayed the most elevated silver maker around the world, with Fresnillo at its front. The organization is versatile and has a designated creation result of in excess of 65 million ounces of silver by 2018 (Investing News Network, 2015).
1.2 Research points and goals
Dissect and assess the monetary exhibition of Fresnillo Plc for the 3 years finished 31st December 2017
Distinguish the elements that have affected the business and monetary execution of Fresnillo over these years These goals would be accomplished by giving solutions to the accompanying inquiries:
What has been the monetary presentation of Fresnillo Plc over the 3 years finishing 31st December 2017, in contrast with Tahoe Resources Inc.?
How has the qualities, shortcomings, potential open doors, and dangers to Fresnillo, impacted their exhibition (both monetary and nonfinancial) over the long term period?
How has Political, Economic, Social, and Technological elements impacted the presentation (monetary and nonfinancial) of Fresnillo?
1.3 Framework for RAP
The report examinations the monetary exhibition of Fresnillo Plc for the 3 years finishing 31st December 2017. This is worked with by the utilization of proportions, for example, productivity, liquidity, equipping, and financial backer proportions.
To more readily assess the presentation of Fresnillo, their exhibition is benchmarked against that of Tahoe Resources Inc.
The report then, at that point, goes further to dissect the effect of the business climate on the presentation of Fresnillo, by utilizing the SWOT system to analyzing its assets, shortcomings, open doors, and dangers. It additionally utilizes the PEST model to evaluate the effect of political, financial, social, and mechanical variables on Fresnillo Plc.
Section 2 – Information assembling and bookkeeping/business strategies
2.1 Sources of data