Pharmacological management of hypertension in the elderly and frail populations

Ashish Correa, Yogita Rochlani, Mohammed Hassan Khan, Wilbert S. Aronow

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Introduction: Cardiovascular disease is a leading cause of mortality in the elderly. Hypertension is an important modifiable risk factor that contributes to cardiovascular morbidity and mortality. The prevalence of hypertension is known to increase with age, and hypertension has been associated with an increase in risk for cardiovascular disease in the elderly. There is a wealth of evidence that supports aggressive control of blood pressure to lower cardiovascular risk in the general population. However, there are limited data to guide management of hypertension in the elderly and frail patient subgroups. These subgroups are inadequately treated due to lack of clarity regarding blood pressure thresholds, treatment targets, comorbidities, frailty, drug interactions from polypharmacy, and high cost of care. Areas covered: We review the current evidence behind the definition, goals, and treatments for hypertension in the elderly and frail and outline a strategy that can be used to guide antihypertensive pharmacotherapy in this population. Expert commentary: Lower blood pressure to < 130/80 mm Hg in elderly patients if tolerated and promote use of combination therapy if the blood pressure is > 20/10 mm Hg over the goal blood pressure. Antihypertensive treatment regimens must be tailored to each individual based on their comorbidities, risk for adverse effects, and potential drug interactions (Figure 1).

Original languageEnglish (US)
Pages (from-to)805-817
Number of pages13
JournalExpert Review of Clinical Pharmacology
Volume11
Issue number8
DOIs
StatePublished - Aug 3 2018
Externally publishedYes

Keywords

  • antihypertensive drug therapy
  • blood pressure
  • elderly
  • frail
  • Hypertension

ASJC Scopus subject areas

  • Pharmacology, Toxicology and Pharmaceutics(all)
  • Pharmacology (medical)

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