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Blood Pressure Targets in the Hypertensive Elderly

Peng Liu1, Jin-Gang Zheng1

  • 1Department of Cardiology, China-Japan Friendship Hospital, Beijing 100029, China.

Chinese Medical Journal
|August 5, 2017
PubMed

Insights

Lowering blood pressure (BP) in healthy elderly individuals (60-80) to below 150/90 mmHg reduces cardiovascular risks. For the very old or frail, cautious, individualized BP management is essential.

Area of Science:

  • Gerontology
  • Cardiology
  • Pharmacology

Background:

  • Hypertension is a significant risk factor for cardiovascular disease and mortality in older adults.
  • Current evidence on optimal blood pressure (BP) targets for the elderly is inconsistent and insufficient.
  • This review addresses the uncertainty surrounding BP targets in hypertensive elderly patients.

Purpose of the Study:

  • To review existing evidence for establishing optimal BP targets in hypertensive elderly individuals.
  • To identify inconsistencies in data regarding BP management in this population.
  • To provide guidance on safe and effective antihypertensive therapy for the elderly.

Main Methods:

  • A comprehensive literature search was conducted in the PubMed database up to March 2017.
  • Keywords used included "hypertension," "elderly," "blood pressure," and "antihypertensive."
  • Articles specifically addressing BP targeting in hypertensive elderly patients were selected for review.

Main Results:

  • Antihypertensive therapy significantly reduces cardiovascular events and mortality in elderly individuals (≥60 years) with systolic BP > 160 mmHg.
  • Evidence for stricter BP targets in the elderly yielded mixed results.
  • For very old and frail patients (≥80 years), intensive antihypertensive therapy may be harmful due to a lack of demonstrated benefit.

Conclusions:

  • Elderly patients (60-80 years) in good health benefit from BP reduction to <150/90 mmHg, with potential further reduction to <140/90 mmHg if tolerated.
  • Individualized assessment and cautious antihypertensive treatment are crucial for the very old and frail.
  • Close monitoring for adverse drug effects is necessary to prevent counterproductive outcomes in elderly patients.
Abstract

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