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Blood pressure management in older people: balancing the risks
1Bait Balev Nesher and The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Postgraduate Medical Journal
|March 21, 2018
Summary
Individualized arterial hypertension treatment guidelines are lacking for frail older adults. Lenient blood pressure goals and potential deintensification of antihypertensive treatment are recommended for this population.
Area of Science:
- Gerontology
- Cardiology
- Pharmacology
Background:
- Current arterial hypertension treatment guidelines lack specific recommendations for frail older individuals.
- Management of blood pressure (BP) in this demographic requires careful consideration of unique health factors.
Purpose of the Study:
- To review evidence on managing arterial blood pressure in frail older patients.
- To identify optimal BP measurement methods and targets considering frailty and comorbidities.
Main Methods:
- Literature review focusing on BP measurement techniques, age-related BP optima, and BP goals.
- Analysis of benefits versus risks of antihypertensive therapy in frail older adults.
- Consideration of patient health, frailty, orthostatic, and postprandial hypotension.
Main Results:
- Lenient blood pressure goals are generally advised for older individuals with moderate to severe frailty, multimorbidity, and limited life expectancy.
- Deintensification of antihypertensive treatment may be necessary for this patient group.
Conclusions:
- Tailored BP management strategies are crucial for frail older persons.
- Individualized care, considering frailty and comorbidities, should guide hypertension treatment decisions in the elderly.
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