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How far should we lower blood pressure in the elderly
1Clinical Hypertension Research, Department of Public Health, University of Uppsala, Sweden. lennart.hansson@geriatrik.uu.se
Cardiovascular Drugs and Therapy
|November 21, 2001
Summary
Antihypertensive treatment significantly benefits elderly patients with high blood pressure, reducing stroke, coronary issues, and mortality. Lowering blood pressure to normal levels is recommended for this age group to minimize cardiovascular risks.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Pharmacology
Background:
- Recent large intervention trials have investigated hypertension management in the elderly.
- Effective blood pressure lowering in older adults is now an accepted medical intervention.
- Studies demonstrate positive impacts on stroke, coronary morbidity, and overall mortality.
Purpose of the Study:
- To review evidence from major intervention trials on antihypertensive treatment in the elderly.
- To assess the efficacy of various drug classes in managing hypertension in older populations.
- To determine the optimal blood pressure targets for elderly individuals.
Main Methods:
- Review of large-scale intervention trials including HOT, STONE, Syst-Eur, Syst-China, and STOP-Hypertension-2.
- Inclusion of ongoing studies like SCOPE, evaluating angiotensin II receptor antagonists.
- Analysis of data comparing older therapies (diuretics, beta-blockers) with novel agents (calcium antagonists, ACE inhibitors).
Main Results:
- Elderly hypertensive patients benefit from treatment to the same extent as younger individuals.
- Diuretics, beta-blockers, calcium antagonists, and ACE inhibitors have all shown significant benefits.
- Novel therapies demonstrate efficacy comparable to established treatments.
Conclusions:
- Extensive data from large trials support antihypertensive treatment in the elderly.
- Blood pressure should be lowered to normotensive levels in the elderly to reduce cardiovascular risk.
- Further research is encouraged to specifically address optimal targets in this demographic.