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Hypertension in the elderly: recent developments and insights

Hillel Sternlicht1, Jan Basile2

  • 1Division of Nephrology and Hypertension, Department of Medicine, Wayne State University School of Medicine-Detroit Medical Center, Detroit, Michigan.

Current Opinion in Cardiology
|May 27, 2020
PubMed

Insights

Intensive blood pressure (BP) control in elderly individuals significantly reduces mortality and heart failure. Lowering BP to 120-130 mmHg systolic benefits those without prior stroke or diabetes, improving cardiovascular and cognitive health.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Nephrology

Background:

  • Recent research explores intensive blood pressure (BP) control in elderly individuals (≥75 years) at high cardiovascular risk.
  • Previous studies focused on BP targets, but new data examines specific outcomes in this demographic.

Purpose of the Study:

  • To review the impact of intensive BP control on cardiovascular, cognitive, and renal outcomes in high-risk elderly individuals.
  • To identify patient subsets who may not benefit and discuss implementation challenges.

Main Methods:

  • Systematic review of recent studies on intensive BP control in elderly populations.
  • Analysis of cardiovascular, cognitive, and renal endpoints based on achieved BP levels.

Main Results:

  • Achieving a systolic BP of 123 mmHg led to significant reductions in all-cause mortality, heart failure, and stroke.
  • Mild cognitive impairment decreased, but dementia incidence showed no benefit.
  • A trend towards modest renal function decline and increased adverse events was observed with BP normalization.

Conclusions:

  • Intensive BP control (systolic goal 120-130 mmHg) lowers mortality and major adverse cardiac events.
  • Elderly individuals with good functional status and no history of diabetes or stroke are ideal candidates for intensive BP management.
Abstract

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