Hypertension Management in the Elderly

Abstract

Hypertension is the most powerful risk factor for cardiovascular disease and mortality globally, especially in the elderly population. In view of aging populations and the high prevalence of hypertension among the elderly, the benefits of lowering blood pressure in the United States and other societies include decreased fatal and nonfatal cardiovascular events and total mortality. Evidence-based guidelines have supported practitioners in carefully treating this special population. Nevertheless, the guidelines have provided inconsistent recommendations regarding target blood pressure in the elderly. There is a delicate balance between both the benefits (including preserving autonomy and quality of life) and the harms of antihypertensive therapy that should be considered when treating the elderly population. This chapter highlights past and recent trials among elderly hypertensive patients and summarizes major current and emerging guideline considerations in the elderly population. First step agents include diuretics and calcium channel blockers with additional agents as needed (depending upon compelling indications), to lower blood pressure and decrease cardiovascular outcomes.