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Slow on the Draw—ED Management of Elevated BP in Older Adults

  • Hypertension and Emergency Medicine (J Miller, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this study is to review data surrounding the emergency department management of elevated blood pressure in older adults, including the management of hypertensive crisis and outpatient management of markedly elevated blood pressure.

Recent Findings

Acute lowering of blood pressure in older adults with markedly elevated blood pressure may lead to serious complications without improvements in hospital length of stay, return visits, or mortality. Older adults presenting with elevated blood pressures without evidence of end-organ damage should be referred for outpatient management of their blood pressure. Treatment of hypertensive emergency should follow standard guidelines with additional considerations for aging physiology.

Summary

Acute lowering of elevated blood pressure in older adults without evidence of end-organ damage has the potential for harm. If the emergency physician opts to acutely treat, they should consider the increased risk of side effects in older adults and avoid Beers list medications including short-acting nifedipine and clonidine.

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Authors and Affiliations

  1. Department of Emergency Medicine, William Beaumont University Hospital, 3601 W. 13 Mile Rd, Royal Oak, MI, 48073, USA

    Kianna Eurick-Bering, Brett Todd & Lauren Cameron-Comasco

  2. Oakland University William Beaumont School of Medicine, Rochester, MI, USA

    Brett Todd & Lauren Cameron-Comasco

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  1. Kianna Eurick-Bering
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Correspondence to Lauren Cameron-Comasco.

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Eurick-Bering, K., Todd, B. & Cameron-Comasco, L. Slow on the Draw—ED Management of Elevated BP in Older Adults. Curr Hypertens Rep 26, 107–117 (2024). https://doi.org/10.1007/s11906-023-01284-y

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