Recommendations for the treatment of hypertension in the elderly and very elderly--a scotoma within international guidelines

Swiss Medical Weekly
Hans-Hendrik SchäferThomas Dieterle

Abstract

The recommendations of international scientific societies for the treatment of hypertension in the geriatric population are different. Lack of outcome trials, non-standardised terminology as well as differing levels of evidence contribute to the inconsistencies in the guidelines. This review article compares six international guidelines (ESH-ESC 2007/2009, SHG 2009, DHL 2008, CHEP 2010, NICE 2011 and JNC7 2003) as well as the consensus document of the ACCF/AHA 2011 in terms of their recommendations of drug classes, target blood pressure values and the use of combination therapy. Generally, antihypertensive therapy appears to be clinically beneficial in geriatric patients. Target blood pressure values of <140-150/90 mm Hg and <140/90 mm Hg can be used as a general guideline for octogenarians (80-89 yrs) and septuagenarians (70-79 yrs) respectively. While angiotensin-II converting enzyme inhibitors and diuretics appear to be advantageous in treating combined systolic-diastolic hypertension, calcium-channel blockers and diuretics are to be recommended in the management of isolated systolic hypertension. Combination therapy often increases the efficacy of the treatment as well as patient medication adherence. Furthermore, by making...Continue Reading

Citations

Nov 1, 2013·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Hee Youn ChoiHyeong-Seok Lim
Oct 17, 2015·Journal of Pharmaceutical Policy and Practice·Tariq M AlhawassiLisa G Pont
Apr 2, 2015·The Journal of Clinical Hypertension·Tariq M AlhawassiLisa G Pont
Apr 14, 2019·Wiener klinische Wochenschrift·Joakim HuberPeter Fasching

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