Current Hypertension Reports

, Volume 13, Issue 5, pp 330–337

Update on Pathophysiology and Treatment of Hypertension in the Elderly

Article

DOI: 10.1007/s11906-011-0215-x

Cite this article as:
Cohen, D.L. & Townsend, R.R. Curr Hypertens Rep (2011) 13: 330. doi:10.1007/s11906-011-0215-x

Abstract

Hypertension is common in the elderly, and its prevalence increases with aging. The vascular system is a prototypical aging tissue, and arterial stiffness plays a major role in hypertension as the individual ages. Some unique aging changes in the nitric oxide and angiotensin II pathways are particularly important for vascular aging. Studies focusing on direct measures of vascular stiffness have increased understanding of the pathophysiology behind increased arterial stiffness. Goal blood pressure in the elderly is debated, but based on current outcome data, a goal blood pressure of 150/80–90 mm Hg is reasonable in at least the very elderly. This review discusses in detail the various landmark hypertension studies in the elderly. We recommend use of thiazide diuretics, long-acting calcium channel blockers, and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers as either monotherapy or in combination, with beta-blockers reserved for patients with specific indications.

Keywords

HypertensionElderlyArterial stiffnessJ-curveIsolated systolic hypertensionTherapyBlood pressureAging

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Renal, Electrolyte and Hypertension DivisionUniversity of PennsylvaniaPhiladelphiaUSA