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Hypertension in very old subjects.
1Centre Claude Bernard de Gérontologie, University Paris V, Hôpital Sainte Périne, France.
Summary
For individuals aged 85 and over, the benefits of hypertension treatment are unclear, with conflicting data suggesting a potential positive association between blood pressure and survival in this age group.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Public Health
Background:
- Hypertension management is established for individuals up to 80 years.
- Data on hypertension in individuals aged 85 and over are scarce and conflicting.
- This demographic is the fastest-growing segment in developed nations.
Purpose of the Study:
- To review the current evidence on hypertension and its treatment in individuals aged 85 and over.
- To address the lack of clear guidelines for managing hypertension in the very elderly.
Main Methods:
- Review of existing cohort studies and randomized trials.
- Analysis of the association between blood pressure and survival in the very old.
- Examination of antihypertensive treatment benefits in randomized trials.
Main Results:
- Several cohort studies show a positive association between blood pressure and survival, even after adjustments.
- Randomized trials indicate declining benefits of antihypertensive treatment with age, often absent after 80.
- The SHEP study is an exception, showing benefits in older populations.
Conclusions:
- Individuals aged 85 and over possess unique characteristics necessitating specific research.
- Current treatment decisions for hypertension in the very elderly must rely on cautious extrapolation.
- Further studies are ongoing to clarify optimal hypertension management strategies for this population.