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[Treatment of hypertension in the elderly]

Yoichi Takami, Hiromi Rakugi

    Nihon Rinsho. Japanese Journal of Clinical Medicine
    |May 5, 2015
    PubMed

    Insights

    The revised hypertension guideline (JSH2014) emphasizes individualized treatment for elderly patients, considering their unique physiological differences and quality of life (QOL). Drug therapy is generally recommended for blood pressure ≤ 140/90mmHg, with specific considerations for those over 75.

    Area of Science:

    • Cardiology
    • Geriatrics
    • Pharmacology

    Context:

    • The Japanese Society of Hypertension (JSH) released the JSH2014 guideline, necessitating updated hypertension management strategies.
    • Elderly individuals exhibit significant physiological variability, requiring personalized therapeutic approaches.
    • Quality of Life (QOL) is a crucial factor in treatment decisions for older adults.

    Purpose:

    • To outline the revised hypertension management guidelines (JSH2014) specifically for the elderly population.
    • To provide evidence-based recommendations for drug therapy initiation and target blood pressure levels in older adults.
    • To highlight the importance of individualized assessment and monitoring in hypertension treatment for the elderly.

    Summary:

    • General drug therapy for hypertension is indicated at blood pressure ≤ 140/90mmHg.
    • For individuals over 75 years, especially the frail or those with systolic blood pressure of 140-149 mmHg, treatment indication requires individual assessment.
    • Target blood pressure is < 140/90mmHg for ages 65-74 and < 150/90 mmHg for those over 75. More aggressive control (< 140/90mmHg) may be beneficial if tolerated.
    • In coronary artery disease patients, caution is advised if diastolic blood pressure falls below 70mmHg to prevent increased cardiac event risk.

    Impact:

    • Facilitates more precise and patient-centered hypertension management in the elderly.
    • Aims to improve clinical outcomes and maintain QOL in older hypertensive patients.
    • Supports healthcare providers in making informed treatment decisions based on the JSH2014 guidelines.

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