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Target Blood Pressure in Elderly Hypertensive Patients: How Low Should You Go?

Alberto Zanchetti1

  • 1a Centro di Fisiologia Clinica e Ipertensione, Via F Sforza 35, 20122 Milan, Italy.

Blood Pressure
|April 21, 2017
PubMed

Insights

Hypertension is common in older adults and increases cardiovascular risk. Antihypertensive treatment effectively lowers this risk, with intensive therapy showing greater blood pressure reduction in the elderly without increased adverse events.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Hypertension prevalence increases with age, elevating cardiovascular disease (CVD) risk.
  • Antihypertensive treatment in elderly patients significantly reduces CVD mortality and morbidity.
  • Treatment benefits correlate with the degree of blood pressure reduction.

Purpose of the Study:

  • To review the efficacy and safety of antihypertensive therapies in elderly patients.
  • To discuss the role of intensive blood pressure lowering in this demographic.
  • To highlight new therapeutic options like angiotensin II type 1 receptor antagonists.

Main Methods:

  • Analysis of epidemiological data and randomized controlled trials (RCTs).
  • Review of findings from the Hypertension Optimal Treatment (HOT) Study.
  • Examination of ongoing trials like the Study on Cognition and Prognosis in the Elderly (SCOPE).

Main Results:

  • Intensive antihypertensive therapy in the elderly yields greater blood pressure reduction than in younger patients.
  • No increased risk of adverse events was observed with intensive therapy in elderly individuals.
  • Current guidelines recommend targeting high-normal blood pressure (below 140/90 mmHg) in elderly patients.

Conclusions:

  • Aggressive blood pressure control is recommended for elderly hypertensive patients.
  • Angiotensin II type 1 receptor antagonists represent a promising therapeutic avenue.
  • Further research, including trials like SCOPE, is crucial to confirm long-term outcomes.

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