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[Screening and management of hypertension in elderly]

C Ferrer Soler, G Ehret, A Pechère-Bertschi

    Revue Medicale Suisse
    |November 7, 2015
    PubMed

    Insights

    Hypertension is common in older adults and poses significant mortality risks. Diagnosing and managing hypertension in the elderly presents unique challenges due to specific physiological changes and potential treatment complications.

    Area of Science:

    • Gerontology
    • Cardiovascular Medicine
    • Public Health

    Context:

    • Aging population leads to increased prevalence of hypertension.
    • Hypertension is a major risk factor for mortality in the elderly.
    • Specific diagnostic and management challenges exist in elderly hypertension.

    Purpose:

    • To highlight the unique diagnostic and management pitfalls of hypertension in the elderly.
    • To discuss the altered phenotype of hypertension in older adults.
    • To emphasize the risks of overtreatment in this population.

    Summary:

    • Elderly hypertension exhibits distinct phenotypes: white coat effect, non-dipping, orthostatic hypotension, dysautonomia, and pseudohypertension.
    • Pure systolic hypertension and increased blood pressure variability are hallmarks.
    • Diagnosis is challenging, with risks of overtreatment, falls, and hypoperfusion, especially in frail or polymedicated individuals.

    Impact:

    • Improved understanding of elderly hypertension phenotypes can refine diagnostic strategies.
    • Awareness of overtreatment risks can lead to safer management protocols.
    • Addresses a critical public health issue concerning the growing elderly population and cardiovascular disease.

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