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Related Experiment Videos

Hypertension and the elderly

J F Potter1

  • 1University Department of Medicine, Glenfield Hospital, Leicester, UK.

British Medical Bulletin
|April 1, 1994
PubMed
Summary
This summary is machine-generated.

Treating hypertension in elderly patients, especially those with systolic blood pressure over 160 mmHg, significantly reduces cardiovascular risks. Thiazide diuretics and beta-blockers are recommended first-line treatments for this population.

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Area of Science:

  • Gerontology
  • Cardiology
  • Pharmacology

Background:

  • Cardiovascular disease is a leading cause of death in the elderly.
  • Hypertension is the primary treatable risk factor for cardiovascular disease in older adults.
  • There has been a lack of consensus on the assessment and treatment of hypertension in the elderly.

Purpose of the Study:

  • To review the evidence for treating hypertension in elderly patients.
  • To provide guidance on the assessment and management of hypertension in this demographic.
  • To highlight the benefits of antihypertensive therapy in reducing cardiovascular morbidity and mortality.

Main Methods:

  • Review of recent large intervention trials on blood pressure reduction in elderly hypertensive patients.
  • Analysis of data regarding the efficacy of thiazide diuretics and beta-blockers.

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  • Consideration of treatment guidelines for elderly patients with specific blood pressure thresholds.

    • Main Results:

    • Blood pressure reduction in elderly patients with combined and isolated systolic hypertension using thiazide diuretics or beta-blockers significantly reduces cardiovascular morbidity and mortality.
    • The STOP-Hypertension Trial demonstrated a reduction in total mortality with active treatment.
    • Patients under 80 with SBP ≥ 160 mmHg and DBP ≥ 90 mmHg or SBP ≥ 160 mmHg and DBP < 90 mmHg should be considered for antihypertensive therapy.

    Conclusions:

    • Negative attitudes towards treating hypertension in the elderly are no longer justifiable.
    • Thiazide diuretics and beta-blockers are established first-line pharmacological therapies.
    • Long-term benefits of other antihypertensive agents require further assessment; benefits in certain subgroups remain unproven.