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Managing Hypertension in the Elderly: What is Different, What is the Same?

Wilbert S Aronow1

  • 1Cardiology Division, Department of Medicine, New York Medical College/Westchester Medical Center, Macy Pavilion, Room 141, Valhalla, NY, 10595, USA. wsaronow@aol.com.

Current Hypertension Reports
|July 30, 2017
PubMed

Insights

Intensive blood pressure management in elderly adults significantly reduced cardiovascular events and mortality. Lowering systolic blood pressure to below 120 mmHg proved safe and effective in the SPRINT trial.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Clinical Trials

Background:

  • Hypertension management in the elderly is complex.
  • Previous guidelines suggested less intensive targets for older adults.

Purpose of the Study:

  • To review the management of hypertension in elderly individuals.
  • To present findings from the Systolic Blood Pressure Intervention Trial (SPRINT) relevant to elderly hypertension.

Main Methods:

  • Analysis of the SPRINT trial data involving 2636 participants aged 75 years and older.
  • Comparison of a systolic blood pressure goal of <120 mmHg versus <140 mmHg.

Main Results:

  • Intensive treatment (SBP <120 mmHg) reduced major cardiovascular events by 34% and all-cause mortality by 33%.
  • Heart failure incidence decreased by 38% with intensive treatment.
  • Adverse event rates were comparable between intensive and standard treatment groups.

Conclusions:

  • Lowering systolic blood pressure to <120 mmHg is effective and safe for elderly individuals with hypertension.
  • Intensive blood pressure management benefits even frail elderly individuals.
Abstract

Keywords:
Antihypertensive drug therapyCardiovascular eventsDiastolic blood pressureElderlyHypertensionSystolic blood pressure

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