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[Hypertensive Crisis in the Elderly Patients]
O N Tkacheva1, Yu V Kotovskaya1, K A Eruslanova1
1Russian Clinical and Research Center of Gerontology, N. I. Pirogov Russian National Medical University, Moscow, Russia.
Kardiologiia
|June 10, 2020
Summary
Hypertensive crisis, a sudden dangerous rise in blood pressure, requires immediate reduction. In elderly patients, nonspecific symptoms and comorbidities complicate management, necessitating careful consideration of regular medications.
Area of Science:
- Cardiology
- Geriatrics
- Hypertension Management
Background:
- A hypertensive crisis involves a rapid, severe increase in blood pressure (BP) with associated symptoms and organ damage, mandating immediate BP reduction.
- Uncomplicated hypertensive crisis is now classified as part of malignant (uncontrolled) arterial hypertension in Europe (since 2018) and Russia (since 2020).
- Elderly patients often present with nonspecific symptoms, even with target organ damage, complicating diagnosis.
Purpose of the Study:
- To highlight the diagnostic challenges of hypertensive crisis in elderly patients.
- To emphasize the critical need for individualized management strategies in this demographic.
- To underscore the importance of considering patient comorbidities and regular medications during treatment.
Main Methods:
- Review of current guidelines and clinical presentations of hypertensive crisis.
- Analysis of symptom variability in elderly hypertensive patients.
- Consideration of drug interactions and patient comorbidities in treatment planning.
Main Results:
- Nonspecific symptoms in elderly patients can mask target organ damage during hypertensive crisis.
- Effective management necessitates a thorough understanding of the patient's medical history, including comorbidities and regular medications.
- Potential for adverse drug effects and interactions with chronic therapies must be minimized.
Conclusions:
- Hypertensive crisis management in the elderly requires a nuanced approach due to atypical presentations.
- Physicians must meticulously assess comorbidities and current medications to ensure safe and effective treatment.
- Individualized care plans are essential to mitigate risks and optimize outcomes for elderly patients experiencing hypertensive crisis.
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