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Blood Pressure Targets in the Hypertensive Elderly
1Department of Cardiology, China-Japan Friendship Hospital, Beijing 100029, China.
Chinese Medical Journal
|August 5, 2017
Summary
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.
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