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Managing the elderly patient with hypertension: current strategies, challenges, and considerations

Wilbert S Aronow1

  • 1Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Vaslhalla, NY, USA.

Expert Review of Cardiovascular Therapy
|February 19, 2020
PubMed

Insights

Hypertension management in older adults involves lifestyle changes and medication, guided by recent ACC/AHA and ESC/ESH guidelines. Individualized treatment is crucial for elderly patients with comorbidities.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Hypertension is a primary modifiable risk factor for global cardiovascular events and mortality.
  • Managing hypertension in the elderly is critical due to age-related physiological changes and increased cardiovascular risk.

Purpose of the Study:

  • To review current clinical trials and guidelines for treating hypertension in the elderly.
  • To discuss the application of the 2017 ACC/AHA and 2018 ESC/ESH hypertension guidelines in older populations.
  • To address the treatment of resistant hypertension in elderly individuals.

Main Methods:

  • Extensive literature review of PubMed articles and clinical trials from 1976 to January 2020.
  • Focus on studies concerning hypertension treatment in the elderly population.
  • Analysis of major hypertension guidelines relevant to elderly care.

Main Results:

  • The 2017 ACC/AHA guidelines recommend treating elderly individuals (≥65 years) with SBP ≥130 mmHg using lifestyle and medication to achieve <130/80 mmHg.
  • Treatment decisions for elderly patients with comorbidities require clinical judgment, patient preference, and a team-based risk/benefit assessment.

Conclusions:

  • Current guidelines provide a framework for hypertension management in the elderly.
  • Individualized treatment strategies are essential, especially for elderly patients with multiple health issues.
  • Further research may refine treatment protocols for specific elderly subgroups.

Keywords:
Hypertensiondiastolic blood pressureelderlysystolic blood pressure

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