Arterial hypertension in the elderly


Authors: Jan Filipovský
Authors‘ workplace: II. interní klinika LF UK a FN Plzeň
Published in: Vnitř Lék 2018; 64(11): 987-992
Category:

Overview

Hypertension is one of the most common problems at higher age and belongs to the most important cardiovascular risk factors. Subjects aged 65 years and more have typically isolated systolic hypertension with increased pulse pressure as a consequence of decreased elasticity of central arteries. With increasing age, the prevalence of cardiovascular/ renal diseases and diabetes is higher. Therefore, we use drugs that have cardiprotective effect and do not affect negatively concomitant diseases. Diuretics have the largest data from prospective studies, calcium channels blockers are suitable especially in isolated systolic hypertension, and ACE inhibitors tested in high-risk hypertensive patients, especially after stroke. The HYVET study showed that the risk of cardiovascular events and of heart failure is decreased with antihypertensive troroeatment also in subjects aged 80 years and more.

Key words:

hypertension in the elderly – isolated systolic hypertension – pulse pressure – treatment of hypertension


Sources
  1. Widimský J jr, Filipovský J, Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze – verze 2017. Doporučení České společnosti pro hypertenzi. Hypertenze a kardiovaskulární prevence 2018; (Suppl 1): 1–19.
  2. Mancia G, Fagard R et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertension 2013; 31(7): 1281–1357. Dostupné z DOI: <http://dx.doi.org/10.1097/01.hjh.0000431740.32696.cc>.
  3. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008; 358(18): 1887–1898. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0801369>.
  4. Beckett N, Peters R, Tuomilehto J et al. Immediate and late benefits of treating very elderly people with hypertension: results from active treatment extension to Hypertension in the Very Elderly randomized controlled trial. BMJ 2012; 344: d7541. Dostupné z DOI: <http://dx.doi.org/10.1136/bmj.d7541>.
  5. Roush GC, Ernst ME, Kostis JB et al. Head-to-Head Comparisons of Hydrochlorothiazide With Indapamide and Chlorthalidone. Antihypertensive and Metabolic Effects. Hypertension 2015; 65(5): 1041–1046. Dostupné z DOI: <http://dx.doi.org/10.1161/HYPERTENSIONAHA.114.05021>.
  6. Wright JM, Musini VM. First-line drugs for hypertension. Cochrane Database of Systematic Reviews 2009; 3: CD001841. Dostupné z DOI: <http://dx.doi.org/10.1002/14651858.CD001841.pub2>. Update in First-line drugs for hypertension. [Cochrane Database Syst Rev. 2018].
  7. Williamson JD, Supiano MA, Applegate WB et al. Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥ 75 Years. A Randomized Clinical Trial. JAMA 2018; 315(24): 2673–2682. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2016.7050>.
Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 11

2018 Issue 11

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account