Related Experiment Videos
[Hypertension in old age]
1Departamento de Medicina y de Cardiología de Adultos, Escuela de Medicina, Universidad de Puerto Rico.
Insights
Treating hypertension in older adults is effective, reducing death and illness from heart and brain events. Treatment benefits are greater in older patients, with drug choices depending on other health conditions.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Pharmacology
Background:
- Hypertension affects 50% of elderly individuals in industrialized nations.
- Elderly hypertension differs from younger forms, characterized by reduced cardiac output and increased vascular resistance.
- Aging involves physiological changes impacting organ function and drug metabolism.
Purpose of the Study:
- To summarize findings from key hypertension in the elderly studies.
- To evaluate the efficacy of hypertension treatment in older adults.
- To review available pharmacologic agents for elderly hypertension management.
Main Methods:
- Review and synthesis of data from major international hypertension trials (e.g., SHEP, STOP-HYP, MRC).
- Analysis of age-related physiological changes affecting hypertension.
- Examination of pharmacologic treatments and their suitability for elderly patients.
Main Results:
- Intervention studies confirm that treating hypertension in the elderly is efficacious.
- Treatment significantly decreases mortality and morbidity from coronary and cerebrovascular events in older adults.
- Benefits of antihypertensive treatment are more pronounced in older versus younger patients.
Conclusions:
- Hypertension management in the elderly is crucial for reducing adverse cardiovascular and cerebrovascular outcomes.
- Pharmacologic treatment options include diuretics, beta-blockers, vasodilators, calcium-channel blockers, adrenergic blockers, and ACE inhibitors.
- Individualized treatment selection is essential, considering comorbidities and contraindications in elderly patients.
Abstract:
Hypertension occurs in 50% of the elderly persons in industrialized societies. This disorder of the regulation of the arterial blood pressure has different manifestations in different age groups. The young hypertensive usually has an increase in cardiac output and a normal peripheral vascular resistance. The elderly patient with hypertension exhibits a decreased cardiac output and an increased peripheral vascular resistance. In the elderly hypertensive there is a progressive anteriolar narrowing and there is hardening of the largest arteries. The vascular disease that contributes to the hypertension in the elderly also causes hypoperfusion of the target organs. During the aging process there is a decrease in cardiac output, glomerular filtration rate, vital capacity, renal plasma flow and maximal cardiac rate. There are changes in the kidneys and the liver that influence the way different medications are handled by the body. The main findings of the Australian, EWPHE, Coope & Warrender, SHEP, STOP-HYP and MRC studies of hypertension in the elderly have been summarized. The intervention studies have proven that the treatment of hypertension in the elderly patient is efficacious and decreases the mortality and morbidity due to coronary and cerebrovascular events. The pharmacologic agents available for the treatment of hypertension in the elderly are the diuretics, beta blockers, vasodilators, calcium-channel blockers, adrenergic blockers and angiotensin converting enzyme inhibitors. The morbidity and mortality benefits derived from antihypertensive trials are greater for the older than for the younger patients. The pharmacologic antihypertensive agents to be used in older patients will also depend upon the presence or not of associated illnesses in which some agents might be harmful or contraindicated.(ABSTRACT TRUNCATED AT 250 WORDS)