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What is an appropriate blood pressure goal for the elderly: review of recent studies and practical recommendations

Matthew G Denker1, Debbie L Cohen

  • 1Perelman School of Medicine, Renal, Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA, USA.

Clinical Interventions in Aging
|November 21, 2013
PubMed

Insights

Hypertension management in older adults, particularly isolated systolic hypertension, requires careful consideration of age-related vascular changes. Treatment benefits are evident, with individualized systolic blood pressure goals recommended for patients under and over 80 years old.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Clinical Pharmacology

Background:

  • Hypertension is prevalent in the elderly, with isolated systolic hypertension being the most common form.
  • Age-related vascular changes contribute significantly to hypertension in older adults.
  • Elevated systolic blood pressure is linked to increased risks of stroke, cardiovascular disease, and mortality.

Purpose of the Study:

  • To address the complexities and debates surrounding hypertension treatment in the elderly.
  • To provide evidence-based recommendations for blood pressure targets and therapeutic approaches in older hypertensive patients.
  • To highlight the unique challenges in managing hypertension in this demographic, including orthostatic hypotension and drug interactions.

Main Methods:

  • Review of clinical trials and existing literature on hypertension in the elderly.
  • Analysis of the association between blood pressure levels and cardiovascular outcomes in older populations.
  • Consideration of age-specific physiological changes and treatment risks.

Main Results:

  • Clinical trials support the benefit of antihypertensive therapy in older adults, irrespective of age.
  • Recommended systolic blood pressure goal is <140 mmHg for those under 80 and 140-150 mmHg for those 80 and older.
  • Blood pressure reduction is prioritized over specific drug choice, with individualized selection based on comorbidities.

Conclusions:

  • Antihypertensive therapy is beneficial for elderly patients with hypertension.
  • Tailored systolic blood pressure targets are crucial for optimizing outcomes in different age strata within the elderly population.
  • Individualized pharmacotherapy, considering comorbidities and potential drug interactions, is key to effective hypertension management in older adults.

Keywords:
antihypertensive treatmentblood pressure targetelderlyhypertension

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