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Hypertension. Contemporary challenges in geriatric care
George C Francos1, Henry L Schairer
1Jefferson Medical College, Philadlephia, PA, USA.
Insights
High blood pressure (hypertension) often goes untreated, with most patients not reaching target pressures. Effective management frequently requires multiple antihypertensive agents, especially in older adults and special populations.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Background:
- Hypertension is a major risk factor for severe cardiovascular and renal complications.
- Despite available treatments, many hypertensive patients remain unaware, undertreated, or uncontrolled.
- Current treatment guidelines aim for specific blood pressure targets, often unmet in clinical practice.
Purpose of the Study:
- To review the comprehensive management of hypertensive patients.
- To emphasize target blood pressure goals in specific patient groups.
- To address challenges in treating hypertension, particularly in the elderly.
Main Methods:
- Literature review of hypertension management strategies.
- Analysis of treatment adherence and control rates.
- Discussion of pharmacologic approaches and challenges.
Main Results:
- Only 68.4% of individuals with hypertension are aware of their condition.
- A majority of patients (nearly 75%) do not achieve the recommended blood pressure goal of 140/90 mm Hg.
- Most patients require multiple antihypertensive agents for adequate blood pressure control.
Conclusions:
- Optimal hypertension management requires a strategic approach, often involving multiple medications.
- Special attention to target blood pressures is crucial for special populations and older patients.
- Improving patient awareness and treatment adherence is vital for reducing hypertension-related morbidity.
Abstract:
Hypertension has been unequivocally linked to morbid complications such as heart attack, congestive heart failure, renal failure, and stroke. Despite the availability of myriad effective antihypertensive agents, blood pressure remains either untreated or inadequately controlled to even conservative goals in many patients. Only 68.4% of hypertensive individuals are aware of their condition, only 53.6% are under treatment, and nearly 75% fail to reach the recommended target pressure of 140/90 mm Hg. Significantly, only 40 to 50% of hypertensives will be controlled on a single agent, while most patients with more severe hypertension will require 3 or even 4 agents. This article reviews the overall approach to the hypertensive patient, with special emphasis on target blood pressures in special populations and problems frequently encountered in the older patient.
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