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Arterial hypertension in the elderly

Jan Filipovský

    Vnitrni Lekarstvi
    |January 5, 2019
    PubMed

    Insights

    Hypertension in the elderly, particularly isolated systolic hypertension, is common. Antihypertensive treatment, including diuretics and calcium channel blockers, effectively reduces cardiovascular events and heart failure in older adults.

    Area of Science:

    • Gerontology
    • Cardiology
    • Pharmacology

    Background:

    • Hypertension is a prevalent issue in older adults, significantly increasing cardiovascular risk.
    • Isolated systolic hypertension, characterized by increased pulse pressure due to arterial stiffening, is common in individuals aged 65 and above.
    • The co-occurrence of cardiovascular diseases, renal diseases, and diabetes rises with age, complicating hypertension management.

    Purpose of the Study:

    • To review the management of hypertension in the elderly, focusing on treatment strategies that offer cardiprotective effects without negatively impacting comorbid conditions.
    • To highlight the efficacy of specific antihypertensive drug classes in older populations, particularly those with isolated systolic hypertension.

    Main Methods:

    • Review of prospective studies and clinical trials, including the HYVET study.
    • Analysis of drug classes such as diuretics, calcium channel blockers, and ACE inhibitors for their use in elderly hypertensive patients.
    • Consideration of treatment benefits in high-risk populations and those with specific conditions like stroke.

    Main Results:

    • Diuretics are supported by extensive data from prospective studies.
    • Calcium channel blockers are particularly effective for isolated systolic hypertension.
    • Antihypertensive treatment, as demonstrated by the HYVET study, significantly reduces the risk of cardiovascular events and heart failure in individuals aged 80 and over.

    Conclusions:

    • Antihypertensive therapy is beneficial for individuals aged 80 and above, reducing cardiovascular events and heart failure.
    • Drug selection should consider cardiprotective effects and potential interactions with common comorbidities in the elderly.
    • Specific agents like calcium channel blockers are well-suited for isolated systolic hypertension in this demographic.

    Keywords:
    hypertension in the elderly - isolated systolic hypertension - pulse pressure - treatment of hypertension

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