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[ACE inhibitors in the treatment of hypertension in elderly patients]
D Evéquoz1, T Reichenstein, B Waeber
1Division d'hypertension, CHUV, Lausanne.
Insights
Hypertension is a major risk for elderly cardiovascular disease. Angiotensin-converting enzyme (ACE) inhibitors are effective first-line treatments, often combined with diuretics or calcium antagonists for optimal blood pressure control.
Area of Science:
- Gerontology
- Cardiology
- Pharmacology
Context:
- Epidemiological studies show blood pressure increases with age.
- Hypertension is a significant risk factor for cardiovascular disease in older adults.
- Effective antihypertensive therapy is crucial for reducing stroke and heart failure incidence in the elderly.
Purpose:
- To highlight the role of angiotensin-converting enzyme (ACE) inhibitors in managing hypertension in elderly patients.
- To discuss the efficacy and tolerability of ACE inhibitors as first-line treatment.
- To outline rational combination therapies for elderly hypertensive patients.
Summary:
- ACE inhibitors are recommended as first-line antihypertensive drugs for elderly patients due to their clinical efficiency and good tolerability.
- ACE inhibition is expected to normalize blood pressure in 40-60% of patients.
- When monotherapy is insufficient, combining ACE inhibitors with diuretics or calcium antagonists represents a rational therapeutic strategy.
Impact:
- Accurate antihypertensive therapy, particularly with ACE inhibitors, can reduce cardiovascular morbidity and mortality in the elderly.
- This approach contributes to improved patient outcomes and quality of life for hypertensive seniors.
- Optimizing treatment strategies for elderly hypertension is essential for public health and healthcare systems.
Abstract:
Recent epidemiological studies clearly indicate that blood pressure rises with age and that hypertension remains a major risk factor for cardiovascular morbidity and mortality in the elderly. An accurate antihypertensive therapy reduces in these patients the incidence of stroke and heart failure. Because of their clinical efficiency and good therapeutic tolerance, the angiotensin-converting enzyme (ACE) inhibitors are first-line drugs for the treatment of elderly hypertensive patients. ACE inhibitions is expected to normalize blood pressure in approximately 40-60% of the patients. When needed, they can be combined with other drugs of different antihypertensive properties. In these cases, the most rational combination therapy consists of an ACE inhibitor with a diuretic or a calcium antagonist.