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Perspective on hypertension in the elderly.

B Whitcomb1, R L Byyny

  • 1Division of Internal Medicine, University of Colorado Health Sciences Center, Denver.

The Western Journal of Medicine
|April 1, 1990
PubMed
Summary
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Elderly hypertension significantly increases health risks. Treatment, especially antihypertensive therapy, is recommended for most older adults to reduce cardiovascular events and mortality.

Area of Science:

  • Gerontology
  • Cardiology
  • Pharmacology

Background:

  • Hypertension affects over 50% of elderly individuals, posing significant morbidity and mortality risks.
  • The etiology of hypertension in the elderly remains unclear, often coexisting with left ventricular hypertrophy and diastolic dysfunction.
  • While isolated systolic hypertension's treatment benefits are debated, evidence supports antihypertensive therapy for those up to age 80.

Purpose of the Study:

  • To review the current understanding of hypertension in the elderly.
  • To discuss the risks and benefits of treating hypertension in older adults.
  • To outline considerations for pharmacologic management in this population.

Main Methods:

  • Literature review of studies on elderly hypertension, cardiovascular disease, and antihypertensive treatments.

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  • Analysis of factors influencing treatment decisions, including comorbidities and drug interactions.
  • Consideration of age-related changes in drug metabolism and efficacy.

    • Main Results:

    • Antihypertensive treatment in the elderly (up to age 80) is associated with reduced cardiovascular morbidity and mortality.
    • Nonpharmacologic therapy may be suitable for mild cases without cardiovascular disease, but drug therapy is often necessary.
    • Age-related alterations in drug metabolism and potential drug interactions require careful medication selection.

    Conclusions:

    • Most elderly hypertensive patients warrant antihypertensive treatment to mitigate cardiovascular risks.
    • Treatment selection must account for comorbidities, potential drug interactions, altered pharmacokinetics, and patient-specific factors like cost and convenience.
    • Further research into the specific causes and optimal management strategies for hypertension in the aging population is needed.