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Hypertension-related stroke prevention in the elderly

Wilbert S Aronow1

  • 1Cardiology Division, New York Medical College, Macy Pavilion, Room 138, Valhalla, NY, 10595, USA, wsaronow@aol.com.

Current Hypertension Reports
|August 17, 2013
PubMed

Insights

Lowering blood pressure through lifestyle changes and medication can significantly reduce stroke risk in older adults. Current guidelines offer specific blood pressure targets for different age groups to prevent cardiovascular events.

Area of Science:

  • Cardiology
  • Geriatrics
  • Public Health

Background:

  • Hypertension is a primary risk factor for cardiovascular diseases, including ischemic and hemorrhagic stroke.
  • Antihypertensive therapies and lifestyle modifications are proven to reduce stroke incidence in elderly populations.
  • Various classes of antihypertensive drugs demonstrate comparable efficacy in reducing cardiovascular events for a given blood pressure reduction.

Purpose of the Study:

  • To review and synthesize current guidelines on blood pressure management in elderly individuals at high risk for cardiovascular events.
  • To evaluate the recommended blood pressure targets for adults aged 80 years and older.
  • To compare recommendations from major cardiology and hypertension societies regarding blood pressure goals.

Main Methods:

  • Analysis of expert consensus documents and clinical trial data, specifically the Hypertension in the Very Elderly trial.
  • Review of guidelines from the American College of Cardiology Foundation/American Heart Association (2011) and the European Society of Hypertension (2013).
  • Comparison of recommended systolic and diastolic blood pressure targets for different age groups and risk levels.

Main Results:

  • The 2011 ACCF/AHA guidelines recommended <140/90 mm Hg for adults <80 years and 140-145 mm Hg systolic for adults ≥80 years.
  • The 2013 ESH guidelines suggested that <130/80 mm Hg is unsupported by data for high-risk adults.
  • The ESH recommended <140 mm Hg systolic for high-risk adults and 140-150 mm Hg systolic for adults ≥80 years.

Conclusions:

  • Blood pressure reduction strategies are crucial for mitigating stroke risk in the elderly.
  • Specific blood pressure targets vary between guidelines, particularly for very elderly individuals (≥80 years).
  • Evidence supports individualized blood pressure management in older adults, considering age and cardiovascular risk.

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