The Elderly Diabetic Patient With Hypertension: Guidelines for Prescribing Antihypertensive Therapy

Diabetes mellitus and hypertension commonly coexist in elderly patients. The benefits of antihypertensive therapy have been clearly defined in the elderly population, but the choice of antihypertensive agents must be based on careful patient evaluation. The elderly patient with diabetes requires evaluation of metabolic and cardiovascular status before therapy is instituted. Antihypertensive therapy should be initiated only after the potential for life-style modifications has been exhausted. The goals of drug therapy are to reduce blood pressure without worsening underlying disease processes or increasing cardiovascular risk factors. Other important considerations in the elderly population include the age-related decline in renal and hepatic function, which may reduce metabolic capacity, the potential for polypharmacy, medication cost, and compliance issues.