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Management of hypertension in older persons

Lori M Dickerson1, Maria V Gibson

  • 1Medical University of South Carolina, Charleston, South Carolina 29406, USA. macfarll@musc.edu

American Family Physician
|February 17, 2005
PubMed

Insights

Antihypertensive therapy benefits older adults, including those over 80, by reducing cardiovascular risks. However, blood pressure control remains a challenge, necessitating careful medication selection based on individual health factors.

Area of Science:

  • Gerontology
  • Cardiology
  • Pharmacology

Background:

  • Antihypertensive therapy significantly reduces morbidity and mortality in older adults with elevated blood pressure.
  • Despite known benefits, less than one-third of elderly patients achieve adequate blood pressure control.
  • Systolic blood pressure is a critical predictor of cardiovascular disease in this demographic.

Purpose of the Study:

  • To review the efficacy and challenges of antihypertensive therapy in patients over 80 years old.
  • To emphasize the importance of blood pressure management in older populations.
  • To guide the selection of antihypertensive medications for elderly patients.

Main Methods:

  • Literature review of studies on antihypertensive therapy in older adults.
  • Analysis of blood pressure control rates in patients over 80.
  • Evaluation of medication classes for treating hypertension in the elderly.

Main Results:

  • Antihypertensive therapy demonstrates persistent benefits in patients older than 80.
  • Orthostatic hypotension assessment is crucial during blood pressure measurement in older persons.
  • Low-dose thiazide diuretics are recommended as first-line treatment.

Conclusions:

  • Effective blood pressure management is vital for reducing cardiovascular disease in older adults.
  • Second-line agents like beta blockers, ACE inhibitors, ARBs, and CCBs should be chosen based on comorbidities.
  • Optimizing antihypertensive strategies is essential for improving health outcomes in the elderly.

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