01/22/2010 - Articles
Is hypertension treatment for the elderly too aggressive?
By: Susan Aldridge, medical journalist, PhD
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Hypertension, also known as high blood pressure, is a health risk for people of all ages.
Hypertension increases the risk of stroke, kidney disease and heart attack. Fortunately, there are many medications which can treat hypertension and keep blood pressure to a healthy level. Usually hypertension drugs are used in combination with the aim of getting blood pressure to 140/90 mm Hg. The guideline is the same for both the over-80s and for younger people. But now the author of a Cochrane clinical review, Dr James Wright, says that he believes hypertension treatment of the over-80s may be too aggressive. In the review, he found only one trial showed an actual reduction in mortality for the over-80s with hypertension treatment. This involved a target blood pressure of 150/80 mm Hg and just three easy steps. This hypertension regime would simplify the treatment of hypertension in the over-80s as well as reducing the cost of treatment. Since the elderly often take many different medications, anything that simplifies their medical management is to be welcomed. Dr Wright suggests that clinical trials should be carried out, comparing the more aggressive with the more conservative approach to controlling hypertension in the over-80s. And, in the meantime, doctors should consider taking a more conservative approach when considering hypertension medication in elderly patients.
Source
Wright J BMJ Clinical Evidence December 2009 and Musini VM et al Pharmacotherapy for hypertension in the elderly. In The Cochrane Library Issue 4 2009
Created on: 01/22/2010
Reviewed on: 01/22/2010
Reviewed on: 01/22/2010
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When a patient is diagnosed with Hypertension, he or she should consider some lifestyle modifications (a treatment option that is completely non-pharmacologic). For example, studies have shown that patients with elevated blood pressure levels benefit from regular exercise (aerobics, jogging, and so on) and from weight reduction. Furthermore, most physicians are known to recommend these measures as the first steps of the therapy for the mild to moderate form of HTN. Patients with this medical condition are also advised to reduce their daily intake of salt, as a less salty diet is able to decrease the elevated blood pressure levels in more than half of the cases.