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Risk: benefit of treating high blood pressure in older adults

Omar Mukhtar1, Stephen H D Jackson

  • 1Clinical Pharmacology & Therapeutics, King's Health Partners, King's College Hospital, Denmark Hill, London, UK. o.mukhtar@nhs.net

British Journal of Clinical Pharmacology
|July 11, 2012
PubMed

Insights

Treating hypertension in older adults (65+) significantly reduces mortality and morbidity. Evidence now supports interventions for both mixed and isolated systolic hypertension in the elderly.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Older adults (65+) represent a growing population segment at high risk for hypertension and its complications.
  • Historically, this demographic was underrepresented in clinical trials, leading to a lack of evidence-based treatment guidelines.
  • Advancements since the 1960s have progressively improved understanding and treatment strategies for hypertension in the elderly.

Purpose of the Study:

  • To review the evolving evidence base for treating hypertension in older adults.
  • To highlight the benefits and risks associated with antihypertensive therapies in this population.
  • To address the historical neglect of elderly participants in cardiovascular clinical trials.

Main Methods:

  • Review of landmark clinical trials and recent studies focusing on hypertension treatment in older populations.
  • Analysis of data from trials including octogenarians, examining mortality and morbidity outcomes.
  • Synthesis of evidence regarding the pathophysiology and treatment of hypertension in the elderly.

Main Results:

  • Early trials focused on severe diastolic hypertension, with limited elderly participation.
  • Recent trials, such as the Hypertension in the Very Elderly Trial, demonstrate significant benefits of treatment.
  • Treatment of mixed systolic-diastolic and isolated systolic hypertension in octogenarians shows positive impacts on mortality and morbidity.

Conclusions:

  • The evidence base for treating hypertension in older adults has substantially progressed.
  • Antihypertensive treatment is beneficial for reducing mortality and morbidity in the elderly population.
  • This review underscores the importance of considering age-specific data in cardiovascular disease management.

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