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Related Experiment Videos

Hypertension in Older Persons.

William C. Cushman1, Henry R. Black

  • 1Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, TN.

Journal of Clinical Hypertension (Greenwich, Conn.)
|June 21, 2001
PubMed
Summary
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Hypertension In The Elderly.

The American journal of geriatric cardiology·1997

Antihypertensive drug treatment effectively reduces cardiovascular risk in older adults with hypertension. However, achieving target blood pressure (BP) goals remains challenging, with fewer than 25% of patients controlled despite available therapies.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Hypertension, particularly elevated systolic blood pressure (SBP), significantly elevates cardiovascular risk in older individuals.
  • Antihypertensive drug therapy has proven effective in reducing cardiovascular events and mortality in this demographic.
  • Lifestyle modifications can aid blood pressure (BP) reduction, but pharmacologic intervention is typically required.

Purpose of the Study:

  • To review the efficacy and challenges of antihypertensive treatment in older populations.
  • To outline recommended therapeutic strategies for managing hypertension in elderly patients.
  • To emphasize the importance of achieving target BP goals for cardiovascular risk reduction.

Main Methods:

  • Review of controlled trials on antihypertensive drug treatment in older persons.

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  • Analysis of lifestyle modifications and pharmacologic interventions for BP control.
  • Evaluation of specific drug classes for hypertension management in the elderly, including diuretics, calcium antagonists, ACE inhibitors, and beta-blockers.

    • Main Results:

    • Antihypertensive drug treatment demonstrably lowers cardiovascular events and mortality in older hypertensive patients.
    • Target BP goals are generally <140/90 mm Hg, or <130/85 mm Hg for diabetics.
    • Achieving target BP levels is difficult in many individuals over 65.
    • Initial treatment for most older hypertensives should involve low-dose diuretics or diuretic-based regimens.
    • Long-acting dihydropyridine calcium antagonists are suitable for isolated systolic hypertension (ISH) when diuretics are ineffective or not tolerated.
    • ACE inhibitors, beta-blockers, and diuretics are effective in reducing cardiovascular events in older hypertensive diabetic patients.
    • Multiple drug therapies are often necessary for effective BP management.
    • Less than 25% of older hypertensive patients achieve controlled BP levels despite available treatments.

    Conclusions:

    • Effective antihypertensive drug therapies exist for older adults, reducing cardiovascular risk.
    • Achieving target blood pressure remains a significant clinical challenge in the elderly population.
    • A combination of pharmacologic agents and adherence to treatment protocols is crucial for optimal outcomes in older hypertensive patients.