Management of hypertension in the elderly

Summary

Hypertension in the elderly is a separate entity characterized by a low cardiac output, impaired myocardial reserve, high peripheral resistance, and contracted intravascular volume. When compared with young subjects with similar arterial pressure, elderly patients have a decreased arterial compliance, renal blood flow, elevated circulating norepinephrine levels, and an increased myocardial mass. Moreover; absorption, protein binding, metabolism, and excretion of various drugs are different in the aged. These pathophysiological and pharmacological alterations have to be taken into account when treating the elderly patient with high blood pressure. Antihypertensive treatment should aim at reducing vascular resistance without affecting systemic flow or compromising blood supply to vital organs such as heart, brain, or kidneys. Often a compromise has to be made between achieving an ideal level of arterial pressure by vigorous antihypertensive treatment and maintaining quality of life with a mild antihypertensive regimen.

Key Words::

• Hypertension
• aged
• drug therapy