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Updated: Jan 19, 2026
Hypertension V: Nursing Management
Published on: June 19, 2025
[Hypertension in the elderly : have new guidelines changed the management ?]
Erietta Polychronopoulou1, Michel Burnier1, Grégoire Wuerzner1
1Service de néphrologie et hypertension, CHUV, 1011 Lausanne.
Insights
New hypertension guidelines for older adults recommend less conservative blood pressure targets and prioritize biological age. Single pill combinations and regular adherence assessments are favored to improve treatment outcomes in the elderly.
Area of Science:
- Geriatrics
- Cardiology
- Neurology
Background:
- Hypertension is a major risk factor for cardiovascular and cerebrovascular events, including cognitive decline, particularly in the elderly.
- Recent guideline updates from AHA/ACC and ESC/ESH address hypertension management in adults over 65 and 85.
Purpose of the Study:
- To summarize the modified approaches to hypertension management in older adults based on recent guidelines.
- To highlight key changes in thresholds, targets, and treatment strategies for elderly hypertensive patients.
Main Methods:
- Review of recently published American Heart Association/American College of Cardiology (AHA/ACC) and European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines.
- Analysis of updated recommendations for hypertension management in patients aged 65 and older, with specific attention to those over 85.
Main Results:
- Guidelines suggest less conservative blood pressure thresholds and targets for individuals over 65.
- Emphasis is placed on biological age over chronological age for treatment decisions.
- Single pill combinations are recommended to simplify treatment and enhance long-term adherence.
Conclusions:
- Updated hypertension guidelines offer a more tailored approach for elderly patients.
- Focus on biological age, simplified medication regimens, and adherence monitoring are key to improving outcomes in geriatric hypertension.
Abstract:
Hypertension is highly prevalent in elderly and represents the number one risk factor for cardiac and cerebrovascular complications including cognitive dysfunction. Recently published AHA/ACC and ESC/ESH guidelines for the management of hypertension in adults have modified the approach of hypertension in patients older than 65 years and particularly in those older than 85. The new concepts are the following: the thresholds and target blood pressures for patients older than 65 years are less conservative; emphasis is made on biological rather than chronological age; the use of single pill combinations is favored to simplify treatment algorithms and increase long-term drug adherence. At last, a regular assessment of adherence in collaboration with health care partners is highlighted.
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