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[Hypertension in the elderly]

Intza Hernandorena1, Henri Bailly1, Matthieu Piccoli1

  • 1Hôpital Broca, université Paris Descartes, gériatrie, 54-56, rue Pascal, 75013 Paris, France; AP-HP, hôpital Broca, EA 4468, 75013 Paris, France.

Presse Medicale (Paris, France : 1983)
|January 23, 2019
PubMed

Insights

Antihypertensive treatment in individuals over 80 significantly cuts cardiovascular events. Blood pressure targets for the elderly vary based on frailty, with recent trials supporting lower goals for improved outcomes.

Area of Science:

  • Gerontology
  • Cardiology
  • Pharmacology

Background:

  • Antihypertensive treatment is crucial for reducing cardiovascular events in individuals over 80 years old.
  • Blood pressure targets in the elderly are individualized based on frailty and comorbidities.
  • Recent European and French guidelines offer specific recommendations for managing hypertension in older adults.

Purpose of the Study:

  • To review current guidelines and evidence for antihypertensive treatment targets in elderly patients (over 80).
  • To discuss the individualized approach to blood pressure management based on patient frailty.
  • To outline the main drug classes used and safety monitoring considerations.

Main Methods:

  • Review of French and European hypertension guidelines for the elderly.
  • Analysis of recent randomized controlled trials on blood pressure targets in older adults.
  • Discussion of pharmacological options and safety monitoring protocols.

Main Results:

  • French guidelines suggest SBP <150 mmHg for those over 80, adjusted for frailty.
  • European guidelines propose stricter targets (130-139/70-79 mmHg) for robust elderly and less strict for frail individuals.
  • A recent trial demonstrated reduced mortality and cardiovascular events with lower blood pressure goals in patients over 75.

Conclusions:

  • Hypertension management in the elderly requires individualized blood pressure targets based on frailty.
  • Robust elderly patients may benefit from more ambitious blood pressure goals.
  • Appropriate drug selection, monitoring, and safety assessments are essential for effective antihypertensive therapy in older adults.

Keywords:
ElderlyFragilitéFrailtyHypertensionHypertension artériellePersonne âgée

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