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Treatment of hypertension in the elderly

Wilbert S Aronow1

  • 1Divisions of Cardiology, Geriatrics, and Pulmonary/Critical Care, New York Medical College, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.

Geriatrics
|October 3, 2008
PubMed

Insights

Antihypertensive drug therapy significantly reduces cardiovascular events and mortality in elderly individuals. Treatment aims to lower blood pressure, but potential side effects like falls must be monitored.

Area of Science:

  • Gerontology
  • Cardiology
  • Pharmacology

Background:

  • Numerous double-blind, randomized, placebo-controlled studies confirm the benefits of antihypertensive drug therapy in reducing cardiovascular events in elderly populations.
  • The Hypertension in the Very Elderly Trial (HYVET) provides key data on treatment efficacy in individuals aged 80 years and older.

Purpose of the Study:

  • To summarize the evidence supporting antihypertensive drug therapy in elderly individuals.
  • To outline treatment goals and potential adverse effects in this demographic.

Main Methods:

  • Review of double-blind, randomized, placebo-controlled studies, including the Hypertension in the Very Elderly Trial.
  • Analysis of cardiovascular event reduction and mortality data in treated elderly patients.

Main Results:

  • Antihypertensive therapy led to a 30% reduction in stroke, 21% reduction in all-cause mortality, and 64% reduction in heart failure at 1.8-year follow-up in the HYVET study.
  • Target blood pressure goals are <140/90 mmHg, or <130/80 mmHg for those with diabetes or chronic renal insufficiency.

Conclusions:

  • Antihypertensive drug therapy is effective in reducing cardiovascular events and mortality in the elderly.
  • Careful monitoring for adverse effects such as orthostatic hypotension, syncope, and falls is crucial in elderly patients receiving antihypertensive treatment.

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