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Hypertension in elderly management

Answer

The management of hypertension in the elderly involves several key considerations, including the initiation of treatment, choice of antihypertensive agents, and setting of blood pressure (BP) targets.

Initiation of treatment

Choice of antihypertensive agents

  • In patients aged ≥85 years and/or with moderate-to-severe frailty, long-acting dihydropyridine calcium channel blockers (CCBs) or renin–angiotensin system (RAS) inhibitors are recommended, followed if necessary by a low-dose diuretic if tolerated. β-blockers and α-blockers are generally not preferred unless compelling indications exist 
  • In older patients, treatment should start with lower doses and be up-titrated slowly 

Blood pressure targets

Special considerations

In conclusion, the management of hypertension in elderly patients requires individualized care, careful monitoring, and balancing the benefits of treatment with potential risks, considering the patient's clinical status and preferences.

References

1

Hypertension

Specific circumstances

Guidelines

Elderly patients

Pathway
ESH 2023