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Therapy in the elderly hypertensive

University Department of Medicine & Therapeutics, The Western Infirmary, Glasgow, UK

Peter Trenkwalder

Starnberg Hospital, Ludwig Maxmilian University, Munich, Germany

The number of people over the age of 65 years continues to increase. In most societies blood pressure (BP) increases with age and elevated levels of BP are common in the elderly.The elderly are also a high-risk group for cardiovascular (CV) disease, which is the leading cause of death in most developed countries. Several intervention trials have confirmed lower CV disease risk in hypertensive patients aged into their early eighties when treated with a variety of antihypertensive drugs. Whilst there is some limited evidence to suggest that -blockers may not be as effective as thiazide diuretics in reducing coronary heart disease (CHD) or total mortality in the elderly, the combination of the two agents and thiazides alone appear to be as effective as newer agents, such as angiotensin-converting enzyme inhibitors (ACE-I) and calcium antagonists. There was no evidence from these trials that BP reduction in the elderly was associated with any deleterious effects.

Whilst the benefits of treating the elderly hypertensive are well established, some issues remain to be clarified, particularly in relation to treating the very elderly and the potential benefits beyond BP control that may be afforded by newer antihypertensive agents.

Key Words: hypertension • elderly • antihypertensive therapy • age • cardiovascular risk • cost benefit • quality of life • randomised control trial • isolated systolic hypertension

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Journal of Renin-Angiotensin-Aldosterone System, Vol. 3, No. 1 suppl, S49-S56 (2002)
DOI: 10.3317/jraas.2002.031


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Meredith, P. A Articles by Trenkwalder, P. Search for Related Content PubMed PubMed Citation Articles by Meredith, P. A Articles by Trenkwalder, P. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Seniors' Health Social Bookmarking                         What's this?