[Arterial hypertension in old age with the focus on 80]

Area of Science:

• Gerontology
• Cardiology
• Internal Medicine

Background:

• Untreated hypertension in older adults elevates risks for secondary conditions like stroke, myocardial infarction, and heart failure.
• Current guidelines offer varying treatment targets based on age and frailty, necessitating careful consideration.

Purpose of the Study:

• To review and synthesize current guidelines for managing hypertension in the elderly.
• To provide recommendations for individualized treatment targets and medication selection in older adults with arterial hypertension.

Main Methods:

• Literature review of current European guidelines on hypertension management in older adults.
• Analysis of treatment recommendations for different frailty levels and age groups.
• Consideration of polypharmacy and multimorbidity in treatment selection.

Main Results:

• For slightly frail individuals up to 80 years, a target systolic blood pressure of 130-139 mmHg is recommended.
• For those over 80, the same target is suggested, but treatment initiation is advised at ≥160 mmHg systolic.
• For physically disabled or very frail individuals, a tailored approach with a target systolic value <150 mmHg (but not below 130/70 mmHg) is recommended.

Conclusions:

• Arterial hypertension in old age can often be managed effectively following guidelines, with individualized approaches for frail patients.
• Careful selection of antihypertensive medications is crucial, considering polypharmacy and potential drug interactions.
• Treatment should be adapted based on patient tolerance and specific clinical circumstances.