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Hypertension and its management in the elderly

Basil O Burney1, George L Bakris

  • 1Department of Medicine, Hypertensive Diseases Unit, University of Chicago Pritzker School of Medicine, Chicago, IL 60637, USA.

Seminars in Nephrology
|December 17, 2009
PubMed

Insights

Lowering blood pressure in older adults, especially those over 70, can prevent cardiovascular events like stroke. Target systolic blood pressure below 140 mm Hg for optimal benefits in the elderly.

Area of Science:

  • Geriatric Medicine
  • Cardiology
  • Clinical Trials

Background:

  • Blood pressure reduction below 140/90 mm Hg is proven to reduce cardiovascular events.
  • Limited outcome trials exist for the elderly cohort (70+ years).

Purpose of the Study:

  • To evaluate the efficacy of blood pressure targets in older adults.
  • To determine optimal systolic blood pressure goals for cardiovascular event reduction in the elderly.

Main Methods:

  • Review of existing cardiovascular outcome trials in the elderly.
  • Analysis of systolic blood pressure ranges (140-149 mm Hg vs. <140 mm Hg) and associated cardiovascular events.
  • Assessment of cognitive side effects related to blood pressure titration.

Main Results:

  • Systolic blood pressure between 140-149 mm Hg significantly reduces cardiovascular events in older adults.
  • Achieving systolic blood pressure below 140 mm Hg without cognitive side effects yields superior outcomes.
  • Cognitive side effects like memory loss and somnolence were considered.

Conclusions:

  • The ideal systolic blood pressure goal for the elderly is less than 140 mm Hg.
  • If <140 mm Hg is not feasible without side effects, a goal below 150 mm Hg is recommended.
  • Blood pressure management in older adults requires careful titration to balance benefits and side effects.

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