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[The treatment of hypertension in the elderly : can it be done safely?]

D Adamopoulos1, U M Vischer

  • 1Service de gériatrie, Département de médecine interne, réhabilitation et gériatrie, Hôpital des Trois-Chêne, HUG, 1226 Thônex.

Revue Medicale Suisse
|December 15, 2011
PubMed

Insights

Treating hypertension in older adults is crucial for preventing stroke and heart failure. Careful blood pressure management, with a systolic target of 150 mmHg, balances efficacy and safety.

Area of Science:

  • Geriatric Medicine
  • Cardiovascular Medicine
  • Pharmacology

Context:

  • Arterial hypertension management in very old patients presents unique safety and quality-of-life challenges.
  • Accurate diagnosis via 24-hour ambulatory blood pressure monitoring or home BP monitoring is essential.
  • Established systolic blood pressure thresholds (150 mmHg office, 135-140 mmHg out-of-office) guide diagnosis and treatment targets.

Purpose:

  • To outline optimal strategies for treating arterial hypertension in the elderly, focusing on safety and efficacy.
  • To define acceptable diagnostic and therapeutic blood pressure targets in this population.
  • To address concerns regarding side effects and treatment intensity.

Summary:

  • Effective hypertension treatment in the elderly is vital for preventing stroke and heart failure.
  • A systolic blood pressure of 150 mmHg (office) or 135-140 mmHg (out-of-office) is a suitable target.
  • Cautious prescribing and avoiding overly intensive regimens are key to ensuring treatment adequacy and minimizing risks like orthostatic hypotension and other comorbidities.

Impact:

  • Informs clinical practice for managing hypertension in very old adults, improving patient outcomes.
  • Highlights the importance of individualized treatment plans considering comorbidities and potential side effects.
  • Emphasizes a balanced approach to antihypertensive therapy, prioritizing safety and quality of life.

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