[Hypertension in the elderly: What we need to know]

Area of Science:

• Geriatric Medicine
• Cardiovascular Health
• Internal Medicine

Background:

• Hypertension prevalence exceeds two-thirds in individuals over 65.
• Comorbidities contribute to a heterogeneous elderly population regarding functional capacity.
• Aging-related vascular stiffness leads to specific hypertension types, such as isolated systolic hypertension.

Purpose of the Study:

• To highlight the unique characteristics of hypertension in the elderly.
• To emphasize factors influencing blood pressure measurement in older adults.
• To underscore the importance of considering these factors in therapeutic decision-making.

Main Methods:

• Clinical blood pressure measurement.
• Consideration of temporal, environmental, and positional influences on blood pressure.
• Review of evidence regarding hypertension management in the elderly.

Main Results:

• Elderly hypertension management is complicated by factors like isolated systolic hypertension and vascular stiffness.
• Blood pressure readings are influenced by circadian rhythms (e.g., absence of night dipping), the white coat phenomenon, and postural changes (orthostatic hypotension).
• Evidence supports that treating hypertension in this age group reduces cardiovascular morbidity and mortality, as well as all-cause mortality.

Conclusions:

• Specialized considerations are necessary for evaluating and managing hypertension in the elderly.
• Accounting for various influences on blood pressure is crucial for effective therapeutic strategies.
• Treatment of hypertension in older adults is associated with significant reductions in adverse health outcomes.