Tolerability of Antihypertensive Medications in Older Adults

Thiruvinvamalai S. Dharmarajan, Lekshmi Dharmarajan

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Several guidelines for hypertension have recently undergone revisions to incorporate an approach providing choices of medications based on age, race, and specific situations where hypertension may co-exist with disorders such as diabetes, coronary artery disease, heart failure and chronic kidney disease. Initial recommendations include diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers; beta blockers are favored in some guidelines and are a choice in specific settings. Within the classes of drugs, several antihypertensive agents provide options. This review discusses antihypertensive drugs by class, including adverse effects and tolerability, with preferences in older adults and specific settings. Adverse drug events from antihypertensive medications are discussed by class and where applicable for specific agents. Data from select studies pertinent to tolerability and adverse effects are presented in tables for several classes of drugs. The rationale for nonadherence to medication is reviewed, including the roles played by tolerability and adverse drug effects. Antihypertensive therapy in typical settings in older adults is discussed; they include hypertension in association with impaired cognition, depression, diabetes, sexual dysfunction, and falls. The key to successful therapy and tolerability is to promote a healthy lifestyle in conjunction with medications as the approach, thereby also lowering the adverse drug effects. The eventual choice of the specific drug(s) is based on risks, benefits, and patient preferences, and is best tailored for each older adult.

Original languageEnglish (US)
Pages (from-to)773-796
Number of pages24
JournalDrugs and Aging
Volume32
Issue number10
DOIs
StatePublished - Oct 1 2015

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Antihypertensive Agents
Pharmaceutical Preparations
Hypertension
Guidelines
Medication Adherence
Patient Preference
Angiotensin Receptor Antagonists
Calcium Channel Blockers
Drug-Related Side Effects and Adverse Reactions
Chronic Renal Insufficiency
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Cognition
Coronary Artery Disease
Heart Failure
Depression
Therapeutics

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Geriatrics and Gerontology

Cite this

Tolerability of Antihypertensive Medications in Older Adults. / Dharmarajan, Thiruvinvamalai S.; Dharmarajan, Lekshmi.

In: Drugs and Aging, Vol. 32, No. 10, 01.10.2015, p. 773-796.

Research output: Contribution to journalArticle

Dharmarajan, Thiruvinvamalai S. ; Dharmarajan, Lekshmi. / Tolerability of Antihypertensive Medications in Older Adults. In: Drugs and Aging. 2015 ; Vol. 32, No. 10. pp. 773-796.
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