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[Heart failure in hypertension in the elderly]

Shinji Seto1

  • 1Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|June 14, 2005
PubMed

Insights

Treating hypertension in elderly patients is crucial for preventing heart failure. Angiotensin-converting enzyme inhibitors, angiotensin-II receptor antagonists, and diuretics are recommended first-line therapies for blood pressure control.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Context:

  • Heart failure, including systolic or diastolic ventricular dysfunction, is prevalent in elderly individuals with hypertension.
  • Recent clinical trials and meta-analyses highlight the significance of managing hypertension in older adults to prevent chronic heart failure.
  • Elderly hypertensive patients often present with comorbidities, target organ damage, and associated cardiovascular conditions.

Purpose:

  • To emphasize the importance of treating hypertension in the elderly to prevent heart failure.
  • To recommend first-line pharmacotherapies for blood pressure control in this demographic.
  • To guide tailored therapeutic choices based on individual patient profiles.

Summary:

  • The incidence and prevalence of heart failure are high in elderly hypertensive patients.
  • Effective blood pressure management using angiotensin-converting enzyme inhibitors, angiotensin-II receptor antagonists, and low-dose diuretics is recommended as a primary strategy.
  • Treatment selection should be individualized, considering additional risk factors and comorbidities, with beta-blockers, aldosterone blockers, and long-acting calcium antagonists being alternative or adjunctive options.

Impact:

  • Improved prevention of chronic heart failure in the elderly population.
  • Enhanced understanding of individualized pharmacotherapy for hypertension in older adults.
  • Potential reduction in cardiovascular morbidity and mortality associated with hypertension and heart failure in the elderly.

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