Benefits of anti-hypertensive therapy in the elderly

Abstract

Hypertension is common in the elderly, up to half of the population over the age of 65 years can be so classified. Raised systolic and diastolic blood pressure levels increase the risk of cardiovascular morbidity and mortality in those aged up to 80 years. Recent intervention studies have shown that antihypertensive treatment reduces death from stroke and myocardial infarction, without producing intolerable side-effects. The benefits of treating isolated systolic hypertension and hypertension following stroke are, as yet, unproven. The therapeutic goals for treating hypertension in the elderly should be to lower blood pressure while keeping adverse reactions to a minimum and thereby not impairing the patient's quality of life. Non-pharmacological methods should be tried initially before resorting to drug therapy. Both thiazide diuretics and beta-adrenoceptor antagonists are of proven value as first line hypotensive agents in the elderly. Drug therapy should be tailored to the individual patient and increased slowly to reduce the incidence of side-effects.

Epidemiology of Hypertension in the Elderly

“…A salt-dependent relationship has been demonstrated in select groups of elderly, but whether this relationship can be generalised is not known (Khaw & Barrett-Connor 1988;Robertson 1989). A strong association exists between hypertension and obesity in the young and middle-aged, but this relationship appears to weaken after the age of 70 (Potter & Haigh 1990).…”