[Heart failure in hypertension in the elderly]

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.