Abstract
The progressive ageing of world population, and the increasing prevalence hypertension in elderly people are leading to the consideration that hypertension in the elderly is one of the main topic in hypertension treatment. Multiple mechanisms, including stiffening of large arteries, endothelial dysfunction, cardiac remodeling, autonomic dysregulation, renal aspects, contribute to the great prevalence of hypertension in the elderly and to increased cardiovascular morbidity and mortality. Treatment of hypertension can hardly put back older patients in a low risk category, especially if target organ damage is present. Nevertheless, blood pressure control can successfully prevent stroke, cognitive decline, coronary heart disease and heart failure, and reduce mortality in the elderly, and even in patients > 80 years, as recently demonstrated. Blood pressure should be lowered below 140/90 mmHg also in older patients. However the HYVET study suggests that a goal of 150/90 mmHg can be reasonable in patients aged 80 years or more. Drug treatment should be titrated with particular caution to adverse responses and excessive blood pressure lowering.
Keywords: Hypertension, elderly, treatment, aortic stiffness, acetylcholine, tetrahydrobiopterin, myocardial infarction, osteoporosis, pseudohypertension, antihypertensive therapy
Current Pharmaceutical Design
Title: Hypertension in the Elderly: An Evidence-based Review
Volume: 17 Issue: 28
Author(s): A. Virdis, R. M. Bruno, M. Fritsch Neves, G. Bernini, S. Taddei and L. Ghiadoni
Affiliation:
Keywords: Hypertension, elderly, treatment, aortic stiffness, acetylcholine, tetrahydrobiopterin, myocardial infarction, osteoporosis, pseudohypertension, antihypertensive therapy
Abstract: The progressive ageing of world population, and the increasing prevalence hypertension in elderly people are leading to the consideration that hypertension in the elderly is one of the main topic in hypertension treatment. Multiple mechanisms, including stiffening of large arteries, endothelial dysfunction, cardiac remodeling, autonomic dysregulation, renal aspects, contribute to the great prevalence of hypertension in the elderly and to increased cardiovascular morbidity and mortality. Treatment of hypertension can hardly put back older patients in a low risk category, especially if target organ damage is present. Nevertheless, blood pressure control can successfully prevent stroke, cognitive decline, coronary heart disease and heart failure, and reduce mortality in the elderly, and even in patients > 80 years, as recently demonstrated. Blood pressure should be lowered below 140/90 mmHg also in older patients. However the HYVET study suggests that a goal of 150/90 mmHg can be reasonable in patients aged 80 years or more. Drug treatment should be titrated with particular caution to adverse responses and excessive blood pressure lowering.
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Cite this article as:
Virdis A., M. Bruno R., Fritsch Neves M., Bernini G., Taddei S. and Ghiadoni L., Hypertension in the Elderly: An Evidence-based Review, Current Pharmaceutical Design 2011; 17 (28) . https://dx.doi.org/10.2174/138161211798157711
DOI https://dx.doi.org/10.2174/138161211798157711 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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