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Angiotensin-converting enzyme inhibitors in the elderly
J L Reid1, N J Macdonald, K R Lees
1Department of Materia Medica, University of Glasgow, Scotland.
American Heart Journal
|March 1, 1989
Summary
Angiotensin-converting enzyme (ACE) inhibitors are effective and well-tolerated for hypertension in older adults. Elderly patients experience significant blood pressure reduction with ACE inhibitors, comparable or greater than younger individuals.
Area of Science:
- Gerontology
- Pharmacology
- Cardiovascular Medicine
Background:
- Early research questioned the utility of ACE inhibitors in elderly hypertensive patients.
- Recent evaluations demonstrate significant efficacy and favorable tolerability in this demographic.
Purpose of the Study:
- To re-evaluate the role and pharmacokinetic profile of ACE inhibitors in older adults with hypertension.
- To compare the blood pressure-lowering effects of ACE inhibitors in elderly versus younger populations.
Main Methods:
- Review of studies evaluating ACE inhibitors (e.g., captopril, enalaprilat, perindopril, benazepril) in elderly hypertensive patients.
- Analysis of pharmacokinetic data, focusing on renal clearance and age-related effects.
- Comparison of blood pressure reduction in elderly versus younger patient groups.
Main Results:
- ACE inhibitors demonstrate significant blood pressure reduction in the elderly, often exceeding that in younger groups.
- Renal elimination of certain ACE inhibitors leads to predictable age-related pharmacokinetic changes, enhancing drug effect duration and intensity.
- Variability exists in the pharmacokinetic profiles of different ACE inhibitors (e.g., perindopril, benazepril) in the elderly.
Conclusions:
- ACE inhibitors are effective antihypertensive agents for the elderly population.
- Wider application of ACE inhibitors is recommended for managing hypertension in older adults.
- Understanding age-related pharmacokinetic differences is crucial for optimizing ACE inhibitor therapy in the elderly.