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Hypertension in the elderly: can we improve results of therapy?
1Section of Cardiology, Hypertension Unit, Medical College of Georgia, Augusta 39012-3105, USA.
Insights
Hypertension management is improving in older adults, but control rates remain low. Despite known benefits, effective blood pressure control is still a challenge in this demographic.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Clinical Pharmacy
Background:
- Hypertension awareness and treatment are increasing in the elderly population in the United States.
- Despite progress, hypertension remains inadequately controlled in older patients.
- Existing data demonstrate that treating hypertension reduces cardiovascular events, yet control rates are low.
Purpose of the Study:
- To examine the current state of hypertension control in older patients.
- To highlight the discrepancy between treatment improvements and control rates in the elderly.
- To underscore the importance of addressing uncontrolled hypertension in this demographic.
Main Methods:
- Review of current data on hypertension awareness and therapy in older patients.
- Analysis of hypertension control rates (systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg).
- Consideration of comorbid diseases and physiological changes in the elderly.
Main Results:
- While awareness and therapy for hypertension have increased in older patients, control rates remain surprisingly low.
- Physiological alterations and comorbidities common in the elderly do not generally impede the effectiveness of antihypertensive drug therapy.
- The benefits of treating both systolic-diastolic and isolated systolic hypertension are well-documented, yet control is lacking.
Conclusions:
- Effective blood pressure control in older adults with hypertension remains a significant clinical challenge.
- Despite age-related physiological changes, antihypertensive drug therapy is generally effective.
- Further efforts are needed to improve hypertension control rates in the elderly to reduce cardiovascular risk.
Abstract:
Awareness of and therapy for hypertension in the United States have been increasing in older patients. Despite this improvement, hypertension continues to be poorly controlled in this patient population. The control rate, defined as systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg, is surprisingly low for older patients, despite abundant data documenting the reduction of cardiovascular events by treating both systolic-diastolic and isolated systolic hypertension. Comorbid diseases and physiological alterations in the elderly, including reduced myocardial contractility, renal function, total body water, baroreceptor responsiveness, and cognitive function, must be considered, but in general these have not limited the effectiveness of antihypertensive drug therapy.