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The case for treating hypertension in the elderly.

W M Smith1

  • 1School of Public Health, University of California, Berkeley.

American Journal of Hypertension
|July 1, 1988
PubMed
Summary

Treating hypertension in older adults is logical due to continued risks and life expectancy. Evidence from younger populations may not directly apply, necessitating specific research for the elderly.

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Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Clinical Pharmacology

Background:

  • Historically, mild hypertension in the elderly was often overlooked due to limited data and concerns about reduced organ perfusion.
  • Previous rationalizations included age as the primary mortality predictor and fears of compromised quality of life with antihypertensive therapy.
  • Older individuals exhibit greater sensitivity to standard medication doses, raising safety concerns.

Purpose of the Study:

  • To evaluate the necessity and efficacy of treating hypertension in elderly individuals.
  • To address the question of whether existing evidence convincingly supports blood pressure control in seniors.
  • To determine if treatment benefits are extrapolated from younger populations or supported by specific elderly data.

Main Methods:

  • Review of existing epidemiological data on hypertension risks in individuals over 65.
  • Analysis of concerns regarding reduced blood flow to vital organs with blood pressure lowering.
  • Examination of the literature on the effectiveness of hypertension treatment in the elderly, particularly stroke survivors.

Main Results:

  • Systolic blood pressure remains a significant predictor of coronary heart disease mortality even in advanced age.
  • Considerable life expectancy persists for many elderly individuals, suggesting a potential benefit from risk reduction.
  • Early literature on hypertension treatment in stroke survivors yielded inconsistent and unconvincing results.

Conclusions:

  • Despite historical hesitations, controlling blood pressure in the elderly is logical to reduce cardiovascular risk and preserve life expectancy.
  • The current evidence base for treating hypertension in the elderly requires critical evaluation.
  • Further research is needed to establish the specific benefits and risks of antihypertensive therapy in older populations.

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