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Treatment of hypertension in the elderly in 2017/2018 - what's new?
1Hypertension Research Foundation , Saint-Légier , Switzerland.
Insights
New hypertension guidelines offer updated recommendations for managing high blood pressure in older adults, emphasizing biological age and simplified treatment for better adherence and outcomes.
Area of Science:
- Cardiology
- Geriatrics
- Hypertension Management
Background:
- Hypertension is common in the elderly, increasing risks for heart disease, stroke, and cognitive decline.
- Recent AHA/ACC and ESC/ESH guidelines update hypertension management for adults, especially those over 85.
Abstract:
Introduction: Hypertension is highly prevalent in the elderly and represents a major risk factor for cardiovascular complications such as coronary heart disease, stroke, and cognitive dysfunction. Areas covered: The recently published AHA/ACC and ESC/ESH guidelines for the management of hypertension in adult populations modified their approach towards hypertension in the elderly, particularly in those older than 85 years. The new concepts presented in these guidelines are discussed. They recommend a less conservative threshold and lower blood pressures targets; an emphasis on considering the biological rather than chronological age for patients >85 years, and the use of single-pill combinations to simplify treatment algorithms and increase long-term drug adherence. Expert opinion: Considering the high prevalence of hypertension in the elderly and the negative impact of untreated hypertension, early detection of hypertension in patients over 60 years old is crucial. The screening of hypertension should be reinforced in patient populations using out-of-office BP measurements. The author supports the latest ESC/ESH guidelines, which define a threshold at >140 mmHg for patients aged 65 to 79 years and >160 mmHg for those >85 years and propose a target BP of 130-140 mmHg, while considering patient frailty and the tolerability of the treatment.
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