Nephrology

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Practical strategies for management of hypertension in the elderly
Geriatrics, 10/21/09

Gibson MV et al. – The major factors contributing to poor blood pressure control include inadequate intensity of treatment, suboptimal drug regimens, high prevalence of resistant hypertension, poor adherence to pharmacotherapy and lifestyle changes, and higher prevalence of concomitant metabolic and cardiovascular complications in older persons. Key strategies for hypertension treatment in elderly include lifestyle changes and hypertension treatment until target BP goal is reached with mono or combination therapy. Thiazide diuretics as first–line therapy are preferred for most uncomplicated hypertensive patients and in conjunction with other agents in patients with high cardiovascular risks or diabetes. Combination therapy should be offered early in the treatment in the presence of subclinical organ damage, cardiovascular disease, renal disease, or diabetes with low doses titrated gradually with regular monitoring for side effects and adherence to therapy.

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