Clinical features of arterial hypertension in the elderly and senile age and the rationale for using the combination of amlodipine/indapamide-retard

Abstract

The proportion of elderly in the population is growing. The two-thirds of those over the age of 65 has arterial hypertension (AH). There is a significant increase in the incidence of isolated systolic hypertension with age. The relationship between increased pulse pressure, arterial stiffness and aging processes has been repeatedly confirmed in population epidemiological studies. Some evidence has been found that the treatment of AH in the elderly is accompanied by a reduction in the risk of cardiovascular diseases. Target levels of blood pressure (BP) in elderly people with AH younger than 80 years, as well as over 80 years with a satisfactory physical and cognitive status with systolic BP ≥ 160 mm Hg is recommended to be reduce to 140-150 mm Hg. Low doses of thiazide diuretics and long-acting calcium channels blockers (mainly dihydropyridine) are attributed to first-line drugs in order to effectively reduce cardiovascular complications in the treatment of AH in the elderly. Their prescription as a fixed-dose combination appears to be an optimal solution when monotherapy is fails.