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Threshold and Target for Blood Pressure Lowering in the Elderly
Guido Grassi1,2, Fosca Quarti-Trevano3, Anna Casati3
1Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy. guido.grassi@unimib.it.
Current Atherosclerosis Reports
|October 25, 2016
Summary
Detecting high blood pressure in older adults is crucial for reducing cardiovascular risk. While the Systolic Blood Pressure Interventional Trial (SPRINT) suggests tight control, current guidelines recommend a more conservative approach for elderly patients.
Area of Science:
- Gerontology
- Cardiology
- Pharmacology
Background:
- Elevated blood pressure in the elderly is common and increases cardiovascular risk.
- Antihypertensive treatment benefits are established, but initiation thresholds and target goals remain debated.
- Both systodiastolic and isolated systolic hypertension in older adults require careful management.
Purpose of the Study:
- To critically review evidence on blood pressure thresholds and goals for antihypertensive drug treatment in the elderly.
- To analyze the impact of recent Systolic Blood Pressure Interventional Trial (SPRINT) findings on elderly hypertension management.
- To evaluate current guidelines and consensus statements regarding antihypertensive therapy in aged individuals.
Main Methods:
- Critical review of existing evidence on antihypertensive treatment in elderly patients.
- Analysis of data from the Systolic Blood Pressure Interventional Trial (SPRINT), including its applicability to the elderly population.
- Evaluation of current clinical guidelines and consensus statements.
Main Results:
- The SPRINT trial demonstrated benefits of intensive blood pressure reduction (systolic blood pressure ≤120 mmHg) in individuals over 75 years.
- However, the SPRINT trial has limitations that restrict its generalizability to all elderly hypertensive patients.
- Current guidelines suggest more conservative blood pressure targets for the general elderly hypertensive population.
Conclusions:
- While intensive blood pressure lowering shows promise, its application in the elderly requires careful consideration of trial limitations.
- A prudent clinical approach involves adopting less intensive, conservative blood pressure targets as recommended by current guidelines.
- Further research and ongoing clinical studies are needed to clarify optimal antihypertensive strategies for elderly patients.
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