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Hypertension in the elderly

W C Cushman1

  • 1University of Tennessee College of Medicine, Memphis.

Current Opinion in Cardiology
|September 1, 1994
PubMed
Summary
This summary is machine-generated.

Treating hypertension in the elderly is crucial for reducing cardiovascular events. Studies show significant benefits from blood pressure management, particularly for systolic hypertension.

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Area of Science:

  • Gerontology
  • Cardiology
  • Public Health

Background:

  • Hypertension is a primary risk factor for cardiovascular events in older adults, affecting over 50% of Americans over 60.
  • Both systolic and diastolic blood pressure increase cardiovascular risk, with systolic pressure being particularly critical in the elderly.
  • Isolated systolic hypertension in the elderly predicts future hypertension and elevates cardiovascular event risk.

Purpose of the Study:

  • To review the evidence supporting hypertension treatment in the elderly.
  • To examine the effectiveness of different antihypertensive drug classes in older populations.
  • To highlight the benefits demonstrated by morbidity trials, such as the Systolic Hypertension in the Elderly Program.

Main Methods:

  • Analysis of morbidity trials focusing on hypertension in the elderly population.

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  • Review of treatment outcomes across different demographic subgroups (e.g., race).
  • Examination of physician prescribing patterns for antihypertensive medications.
  • Main Results:

    • Morbidity trials, including the Systolic Hypertension in the Elderly Program, confirm significant benefits of hypertension treatment in all elderly subgroups.
    • Diuretics and beta-blockers showed benefits, though physician initiation of these therapies was suboptimal in 1990-1991.
    • All major drug classes effectively lower blood pressure in older white patients; calcium antagonists and diuretics are most effective in older black patients.

    Conclusions:

    • Hypertension management is vital for reducing cardiovascular morbidity and mortality in the elderly.
    • Evidence supports the efficacy of various antihypertensive agents, with specific recommendations based on race.
    • Further efforts are needed to ensure optimal pharmacotherapy initiation and adherence in elderly hypertensive patients.