Skip to main content
SpringerLink
Log in

Treatment of Hypertension in Older Persons: What Is the Evidence?

  • Current Opinion
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Evidence for treatment of hypertension in older people is limited to placebo-controlled studies that reduced blood pressure in persons over 60 years who had systolic blood pressure >160 mmHg. Generally, physicians measure blood pressure poorly, failing to look for white coat or masked hypertension, orthostasis, postprandial hypotension, or pseudohypertension. There is evidence that if 24-hour ambulatory blood pressures were obtained, the treatment goal should be substantially lower. Sleep apnea, pain, nocturnal hypoglycemia, drugs, excess aldosterone production, and pheochromocytoma should all be considered as causes of hypertension in older persons. Evidence supports a low-dose diuretic or an angiotensin converting enzyme inhibitor as appropriate first-line therapies in older persons.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Cheung BM, Ong KL, Mann YB, et al. Prevalence, awareness, treatment, and control of hypertension: United States National Health and Nutrition Examination Survey 2001–2002. J Clin Hypertens (Greenwich). 2006;8:93–8.

    Google Scholar 

  2. Ostchega Y, Dillon CF, Hughes JP, et al. Trends in hypertension prevalence, awareness, treatment, and control in older U.S. adults: Data from the National Health and Nutrition Examination Survey, 1998 to 2004. J Am Geriatr Soc. 2007;55:1056–65.

    PubMed  Google Scholar 

  3. Burt VL, Shelton P, Roccella EJ, et al. Prevalence of hypertension in the US adult population: results from the Third National health and Nutritional Examination Survey, 1988–1991. Hypertension. 1995;25:305–13.

    PubMed  CAS  Google Scholar 

  4. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA. 2010;303:2043–50.

    PubMed  CAS  Google Scholar 

  5. Moser M. From JNC, 1 to JNC 7—what have we learned? Prog Cardiovasc Dis. 2006;48:303–15.

    PubMed  Google Scholar 

  6. Materson BJ. JNC8 transmogrified. J Clin Hypertens (Greenwich). 2013;15:704. doi:10.111/jch.12174.

    Google Scholar 

  7. James PA, Opanl S, Carter BL, et al. 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC8). JAMA. 2014;311:507–20.

    PubMed  CAS  Google Scholar 

  8. Mallery LH, Ransom T, Steeves B, et al. Evidence-informed guidelines for treating frail older adults with type 2 diabetes: From the diabetes care program of Nova Scotia (DCPNS) and the palliative and therapeutic harmonization (PATH) program. J Am Med Dir Assoc. 2013;14:801–8.

    PubMed  Google Scholar 

  9. Morley JE, Vellas B, van Kan GA, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14:392–7.

    PubMed  Google Scholar 

  10. von Haehling S, Anker SD, Doehner W, et al. Frailty and heart disease. Int J Cardiol. 2013;168:1745–7.

    Google Scholar 

  11. Musini VM, Tejani AM, Bassett K, Wright JM. Pharmacotherapy for hypertension in the elderly. Cochrane Database Syst Rev. 2009;(4):CD000028. doi:10.1002/14651858.CD000028.pub2.

  12. McGuiness B, Todd S, Passmore P, Bullock R. Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Cochrane Database Syst Rev. 2009;(4):CD004034. doi:10.1002/14651858.CD004034.pub3.

  13. Peters R, Beckett N, Forette F, HYVET investigators, et al. Incident dementia and blood pressure lowering in the hypertension in the very elderly trial cognitive function assessment (HYVET-COG): A double-blind, placebo controlled trial. Lancet Neurol. 2008;7:683–9.

    PubMed  CAS  Google Scholar 

  14. Morley JE. Mild cognitive impairment—a treatable condition. J Am Med Dir Assoc. 2014;15:1–5.

    PubMed  Google Scholar 

  15. Schall P, Wehling M. Treatment of arterial hypertension in the very elderly: a meta-analysis of clinical trials. Arzneimittelforschung. 2011;61:221–8.

    PubMed  CAS  Google Scholar 

  16. Morley JE. Hypertension: is it overtreated in the elderly. J Am Med Dir Assoc. 2010;11:147–52.

    PubMed  Google Scholar 

  17. Mattila K, Haavisto M, Rajala S, Heikinheimo R. Blood pressure and five year survival in the very old. Br Med J Clin Res Ed. 1988;296:887–9.

    PubMed Central  PubMed  CAS  Google Scholar 

  18. Sorensen KH, Hilden T. Increased total mortality and decreased functional capacity are associated with low systolic blood pressure among elderly women. Scand J Prim Health Care. 1988;6:105–10.

    PubMed  CAS  Google Scholar 

  19. Beckett NS, Peters R, Fletcher AE, HYVET Study Group, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358:1887–98.

    PubMed  CAS  Google Scholar 

  20. Bulpitt CJ, Beckett N, Peters R, et al. Does white coat hypertension require treatment over age 80? Results of the hypertension in the very elderly trial ambulatory blood pressure side project. Hypertension. 2013;61:89–94.

    PubMed  CAS  Google Scholar 

  21. Peters R, Beckett N, Burch L, et al. The effect of treatment based on a diuretic (indapamide) +/− ACE inhibitor (perindopril) on fractures in the hypertension in the very elderly trial (HYVET). Age Ageing. 2010;39:609–16.

    PubMed  Google Scholar 

  22. Butt DA, Mamdani M, Austin PC, et al. The risk of hip fracture after initiating antihypertensive drugs in the elderly. Arch Intern Med. 2012;172:1739–44.

    PubMed  Google Scholar 

  23. Berry SD, Zhu Y, Choi H, et al. Diuretic initiation and the acute risk of hip fracture. Osteoporos Int. 2013;24:689–95.

    PubMed Central  PubMed  CAS  Google Scholar 

  24. Morley JE. Frailty, falls and fractures. J Am Med Dir Assoc. 2013;14:149–51.

    PubMed  Google Scholar 

  25. Lalande A, Roux C, Graulet AM, et al. The diuretic indapamide increases bone mass and decreases bone resorption in spontaneously hypertensive rats supplemented with sodium. J Bone Miner Res. 1998;13:1444–50.

    PubMed  CAS  Google Scholar 

  26. Giusti A, Barone A, Pioli G, et al. Alendronate and indapamide alone or in combination in the management of hypercalciuria associated with osteoporosis: a randomized controlled trial of two drugs and three treatments. Nephrol Dial Transplant. 2009;24:1472–7.

    PubMed  CAS  Google Scholar 

  27. Morley JE. Developing novel therapeutic approaches to frailty. Curr Pharm Des. 2009;15(29):3384–95.

    PubMed  CAS  Google Scholar 

  28. Yamada M, Nishiguchi S, Fukutani N, et al. Prevalence of sarcopenia in community-dwelling Japanese older adults. J Am Med Dir Assoc. 2013. pii: S1525-8610(13)00504-5 (Epub ahead of print).

  29. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013;14:531–2.

    PubMed  Google Scholar 

  30. Roman D, Mahoney K, Mohamadi A. Sarcopenia: what’s in a name? J Am Med Dir Assoc. 2013;14:80–2.

    PubMed  Google Scholar 

  31. Morley JE, Abbatecola AM, Argiles JM, Society on Sarcopenia, Cachexia and Wasting Disorders Trialist Workshop, et al. Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc. 2011;12:403–9.

    PubMed  Google Scholar 

  32. Sumukadas D, Witham MD, Struthers AD, McMurdo ME. Effect of perindopril on physical function in elderly people with functional impairment: a randomized controlled trial. CMAJ. 2007;177:867–74.

    PubMed Central  PubMed  Google Scholar 

  33. Hutcheon SD, Gillespie ND, Crombie IK, et al. Perindopril improves six minute walking distance in older patients with left ventricular systolic dysfunction: a randomized double blind placebo controlled trial. Heart. 2002;88:373–7.

    PubMed Central  PubMed  CAS  Google Scholar 

  34. Sumukadas D, Band M, Miller S, et al. Do ACE inhibitors improve the response to exercise training in functionally impaired older adults? A randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2013 (Epub ahead of print).

  35. Duboc D, Meune C, Pierre B, et al. Perindopril preventive treatment on mortality in Duchenne muscular dystrophy: 10 years’ follow-up. Am Heart J. 2007;154:596–602.

    PubMed  CAS  Google Scholar 

  36. Franklin SS, Thijs L, Hansen TW, International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcomes Investigators, et al. Significance of white-coat hypertension in older persons with isolated systolic hypertension: a meta-analysis using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes population. Hypertension. 2012;59:564–71.

    PubMed Central  PubMed  CAS  Google Scholar 

  37. Anzal M, Palmer AJ, Starr J, Bulpitt CJ. The prevalence of pseudohypertension in the elderly. J Hum Hypertens. 1996;10:409–11.

    PubMed  CAS  Google Scholar 

  38. Zuschke CA, Pettyjohn FS. Pseudohypertension. South Med J. 1995;88:1185–90.

    PubMed  CAS  Google Scholar 

  39. Iwanczyk L, Weintraub NT, Rubenstein LZ. Orthostatic hypotension in the nursing home setting. J Am Med Dir Assoc. 2006;7:163–7.

    PubMed  Google Scholar 

  40. Luukinen H, Koski K, Laippala P, Kivela SL. Prognosis of diastolic and systolic orthostatic hypotension in older persons. Arch Intern Med. 1999;159:273–80.

    PubMed  CAS  Google Scholar 

  41. Beckett NS, Connor M, Sadler JD, et al. Orthostatic fall in blood pressure in the very elderly hypertensive: results from the hypertension in the very elderly trial (HYVET)—pilot. J Hum Hypertens. 1999;13:839–40.

    PubMed  CAS  Google Scholar 

  42. Morley JE. Is low blood pressure dangerous? J Am Geriatr Soc. 1991;39:1239–40.

    PubMed  CAS  Google Scholar 

  43. Deegan BM, O’Connor M, Lyons D, O’Laighin G. Development and evaluation of new blood pressure and heart rate signal analysis techniques to assess orthostatic hypotension and its subtypes. Physiol Meas. 2007;28:N87–102.

    PubMed  CAS  Google Scholar 

  44. Vu MQ, Weintraub N, Rubenstein LZ. Falls in the nursing home: Are they preventable? J Am Med Dir Assoc 2006;7(3 Suppl):S53–S58, 52.

    Google Scholar 

  45. Morley JE. Falls—where do we stand? Mol Med. 2007;104:63–7.

    Google Scholar 

  46. Jansen RW, Kelly-Gagnon MM, Lipsitz LA. Intraindividual reproducibility of postprandial and orthostatic blood pressure changes in older nursing-home patients: relationship with chronic use of cardiovascular medications. J Am Geriatr Soc. 1996;44:383–9.

    PubMed  CAS  Google Scholar 

  47. Jansen RW, Lipsitz LA. Postprandial hypotension: epidemiology, pathophysiology, and clinical management. Ann Intern Med. 1995;122:286–95.

    PubMed  CAS  Google Scholar 

  48. Morley JE. Postprandial hypotension—the ultimate Big Mac attack. J Gerontol A Biol Sci Med Sci. 2001;56:M741–3.

    PubMed  CAS  Google Scholar 

  49. Edwards BJ, Perry HM 3rd, Kaiser FE, et al. Relationship of age and calcitonin gene-related peptide to postprandial hypotension. Mech Ageing Dev. 1996;87:61–73.

    PubMed  CAS  Google Scholar 

  50. Jian ZJ, Zhou BY. Efficacy and safety of acarbose in the treatment of elderly patients with postprandial hypotension. Chin Med J (Engl). 2008;121:2054–9.

    Google Scholar 

  51. Lee A, Patrick P, Wishart J, et al. The effects of miglitol on glucagon-like peptide-1 secretion and appetite sensations in obese type 2 diabetics. Diabetes Obes Metab. 2002;4:329–35.

    PubMed  CAS  Google Scholar 

  52. Franklin SS. Elderly hypertensives: how are they different? J Clin Hypertens. 2012;14:779–86.

    Google Scholar 

  53. Franklin SS, Thijs L, Hansen TW, et al. Significance of white-coat hypertension in older person with isolated systolic hypertension: a meta-analysis using the International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes population. Hypertension. 2012;59:565–71.

    Google Scholar 

  54. Franklin SS, Khan SA, Wong ND, et al. Is pulse pressure useful in predicting risk for coronary heart disease? The Framingham Heart Study. Circulation. 1999;100:354–60.

    PubMed  CAS  Google Scholar 

  55. Protogerou AD, Safar ME, Iaria P, et al. Diastolic blood pressure and mortality in the elderly with cardiovascular disease. Hypertension. 2007;50:172–80.

    PubMed  CAS  Google Scholar 

  56. Franklin SS, Chow VH, Mori AD, Wong ND. The significance of low DBP in US adults with isolated systolic hypertension. J Hypertens. 2011;29:1101–8.

    PubMed  CAS  Google Scholar 

  57. Gonzaga CC, Calhoun DA. Resistant hypertension and hyperaldosteronism. Curr Hypertens Rep. 2008;10:496–503.

    PubMed  CAS  Google Scholar 

  58. Mulatero P, Bertello C, Verhovez A, et al. Differential diagnosis of primary aldosteronism subtypes. Curr Hypertens Rep. 2009;11:217–23.

    PubMed  CAS  Google Scholar 

  59. Azizan EA, Poulsen H, Tuluc P, et al. Somatic mutations in ATP1A1 and CACNA1D underlie a common subtype of adrenal hypertension. Nat Genet. 2013;45:1055–60.

    PubMed  CAS  Google Scholar 

  60. Veldhuis JD, Sharma A, Roelfsema F. Age-dependent and gender-dependent regulation of hypothalamic–adrenocorticotropic–adrenal axis. Endocrinol Metab Clin North Am. 2013;42:201–25.

    PubMed  CAS  Google Scholar 

  61. Kopetschke R, Slisko M, Kilisli A, et al. Frequent incidental discovery of phaeochromocytoma: data from a German cohort of 201 phaeochromocytoma. Eur J Endocrinol. 2009;161:355–61.

    PubMed  CAS  Google Scholar 

  62. Dominguez LJ, Bevilacqua M, Dibella G, Barbagallo M. Diagnosing and managing thyroid disease in the nursing home. J Am Med Dir Assoc. 2008;9:9–17.

    PubMed  Google Scholar 

  63. Yokokawa K, Tahara H, Kohno M, et al. Hypertension associated with endothelin-secreting malignant hemangioendothelioma. Ann Intern Med. 1991;114:213–5.

    PubMed  CAS  Google Scholar 

  64. Das AM, Khayat R. Hypertension in obstructive sleep apnea: risk and therapy. Expert Rev Cardiovasc Ther. 2009;7:619–26.

    PubMed  Google Scholar 

  65. Onen SH, Lesourd B, Ouchchane L, et al. Occult nighttime hypertension in daytime normotensive older patients with obstructive sleep apnea. J Am Med Dir Assoc. 2012;13:752–6.

    PubMed  Google Scholar 

  66. Resnick HE, Phillips B. Documentation of sleep apnea in nursing homes: United States 2004. J Am Med Dir Assoc. 2008;9:260–4.

    PubMed  Google Scholar 

  67. Haus DC, Foster GL, Nielo FJ, et al. Age-dependent associations between sleep-disordered breathing and hypertension: importance of discriminating between systolic/diastolic hypertension and isolated systolic hypertension in the Sleep Heart Health Study. Circulation. 2005;111:614–21.

    Google Scholar 

  68. Lukas A, Mayer B, Fialová D, et al. Pain characteristics and pain control in European nursing homes: cross-sectional and longitudinal results from the Services and Health for Elderly in Long TERm care (SHELTER) study. J Am Med Dir Assoc. 2013;14:421–8.

    PubMed  Google Scholar 

  69. Chester JG, Rudolph JL. Vital signs in older patients: age-related changes. J Am Med Dir Assoc. 2011;12:337–43.

    PubMed Central  PubMed  Google Scholar 

  70. Sinclair A, Morley JE. How to manage diabetes mellitus in older persons in the 21st century: applying these principles to long term diabetes care. J Am Med Dir Assoc. 2013;14:777–80.

    PubMed  Google Scholar 

  71. Morley JE. Depression in nursing home residents. J Am Med Dir Assoc. 2010;11:301–3.

    PubMed  Google Scholar 

  72. Pilz S, Tomaschitz A, Ritz E, Pieber TR. Medscape. Vitamin D status and arterial hypertension: a systematic review. Nat Rev Cardiol. 2009;6:621–30.

    PubMed  CAS  Google Scholar 

  73. Morley JE. Anorexia of aging: a true geriatric syndrome. J Nutr Health Aging. 2012;16:422–5.

    PubMed  CAS  Google Scholar 

  74. Soenen S, Chapman IM. Body weight, anorexia, and undernutrition in older people. J Am Med Dir Assoc. 2013;14:642–8.

    PubMed  Google Scholar 

  75. Morley JE. Weight loss in older persons: new therapeutic approaches. Curr Pharm Des. 2007;13:3637–47.

    PubMed  CAS  Google Scholar 

  76. Morley JE. Pathophysiology of the anorexia of aging. Curr Opin Clin Nutr Metab Care. 2013;16:27–32.

    PubMed  CAS  Google Scholar 

  77. Bibbins-Domingo K. The Institute of Medicine Report sodium intake in populations: assessment of evidence: summary of primary findings and implications for clinicians. JAMA Intern Med. 2014;174:136–7. doi:10.1001/jamainternmed.2013.11818.

    PubMed  Google Scholar 

  78. Aliti GB, Rabelo ER, Clausell N, et al. Aggressive fluid and sodium restriction in acute decompensated heart failure: a randomized clinical trial. JAMA Intern Med. 2013;173:1058–64.

    PubMed  CAS  Google Scholar 

  79. Mitka M. IOM report: evidence fails to support guidelines for dietary salt reduction. JAMA. 2013;309:2535–6.

    PubMed  CAS  Google Scholar 

  80. O’Donnell MJ, Yusuf S, Mente A, et al. Urinary sodium potassium excretion and risk of cardiovascular events. JAMA. 2011;306:2229–38.

    PubMed  Google Scholar 

  81. Stolarz-Skrzypek K, Liu Y, Thijs L, et al. Blood pressure, cardiovascular outcomes and sodium intake, a critical review of the evidence. Acta Clin Belg. 2012;67:403–10.

    PubMed  CAS  Google Scholar 

  82. Cohen HW, Hailpern SM, Fang J, Alderman MH. Sodium intake and mortality in the NHANES II follow-up study. Am J Med. 2006;119:275.e7–14.

    PubMed  Google Scholar 

  83. Wright JT Jr, Dunn JK, Cutler JA, et al. Outcomes in hypertensive black and nonblack patients treated with chlorthalidone, amlodipine, and lisinopril. JAMA. 2005;293:1595–608.

    PubMed  CAS  Google Scholar 

  84. Gunathilake R, Oldmeadow C, McEvoy M, et al. Mild hyponatremia is associated with impaired cognition and falls in community-dwelling older persons. J Am Geriatr Soc. 2013;61:1838–9.

    PubMed  Google Scholar 

  85. Miller M, Morley JE, Rubenstein LZ. Hyponatremia in a nursing home population. J Am Geriatr Soc. 1995;43:1410–3.

    PubMed  CAS  Google Scholar 

  86. Thomas DR, Cote TR, Lawhorne L, Dehydration Council, et al. Understanding clinical dehydration and its treatment. J Am Med Dir Assoc. 2008;9:292–301.

    PubMed  Google Scholar 

  87. Silver AJ, Morley JE. Role of the opioid system in the hypodipsia associated with aging. J Am Geriatr Soc. 1992;40:556–60.

    PubMed  CAS  Google Scholar 

  88. Moser M, Feig PU. Fifty years of thiazide diuretic therapy for hypertension. Arch Intern Med. 2009;169:1851–6.

    PubMed  CAS  Google Scholar 

  89. Yusuf S, Teo KK, Pogue J, ONTARGET Investigators, et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008;358:1547–59.

    PubMed  CAS  Google Scholar 

  90. Fried LF, Emanuele N, Zhang JH, et al. Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med. 2013;369:1892–903.

    PubMed  CAS  Google Scholar 

  91. Anonymous. Medical Research Council trial of treatment of hypertension in older adults: principal results. MRC Working Party. BMJ. 1992;304:405–12.

  92. Fraser HS. Reserpine: a tragic victim of myths, marketing, and fashionable prescribing. Clin Pharmacol Ther. 1996;60:368–73.

    PubMed  CAS  Google Scholar 

  93. Griebenow R, Pittrow DB, Weidinger G, et al. Low-dose reserpine/thiazide combination in first-line treatment of hypertension: efficacy and safety compared to an ACE inhibitor. Blood Press. 1997;6:299–306.

    PubMed  CAS  Google Scholar 

  94. Krönig B, Pittrow DB, Kirch W, et al. Different concepts in first-line treatment of essential hypertension. Comparison of a low-dose reserpine-thiazide combination with nitrendipine monotherapy. German Reserpine in Hypertension Study Group. Hypertension. 1997;29:651–8.

    PubMed  Google Scholar 

  95. Messerli FH. Vasodilatory edema: a common side effect of antihypertensive therapy. Curr Cardiol Rep. 2002;4:479–82.

    PubMed  Google Scholar 

  96. JATOS Study Group. Principal results of the Japanese trial to assess optimal systolic blood pressure in elderly hypertensive patients (JATOS). Hypertens Res. 2008;31:2115–27.

    Google Scholar 

  97. Rakugi H, Ogihara T, Goto Y, Ishii M, JATOS Study Group. Comparison of strict- and mild-blood pressure control in elderly hypertensive patients: a per-protocol analysis of JATOS. Hypertens Res. 2010;33:1124–8.

    PubMed  Google Scholar 

  98. Supiano MA. Healthy people aged 80 and older with systolic blood pressure greater than 150 mmHg should be treated. J Am Geriatr Soc. 2013;61:1199–200.

    PubMed  Google Scholar 

  99. Tolson D, Rolland Y, Andrieu S, et al. International Association of Gerontology and Geriatrics: a global agenda for clinical research and quality of care in nursing homes. J Am Med Dir Assoc. 2011;12:184–9.

    PubMed  Google Scholar 

  100. Lopez D, Flicker L, Dobson A. Validation of the frail scale in a cohort of older Australian women. J Am Geriatr Soc. 2012;60:171–3.

    PubMed  Google Scholar 

  101. Hyde Z, Flicker L, Almeida OP, et al. Low free testosterone predicts frailty in older men: the health in men study. J Clin Endocrinol Metab. 2010;95:3165–72.

    PubMed  CAS  Google Scholar 

  102. Woo J, Leung J, Morley JE. Comparison of frailty indicators based on clinical phenotype and the multiple deficit approach in predicting mortality and physical limitation. J Am Geriatr Soc. 2012;60:1478–86.

    PubMed  Google Scholar 

  103. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16:601–8.

    PubMed  CAS  Google Scholar 

  104. Ravindrarajah R, Lee DM, Pye SR, et al. The ability of three different models of frailty to predict all-cause mortality: results from the European Male Aging Study (EMAS). Arch Gerontol Geriatr. 2013;57:360–8.

    PubMed  Google Scholar 

  105. Welsh T, Gladman J, Gordon AL. The treatment of hypertension in care home residents: a systematic review of observational studies. J Am Med Dir Assoc. 2014;15:8–16.

    PubMed  Google Scholar 

  106. Aronow WS. Treatment of hypertension in the elderly. J Am Med Dir Assoc. 2013;14:847.

    PubMed  Google Scholar 

  107. Koka M, Joseph J, Aronow WS. Adequacy of control of hypertension in an academic nursing home. J Am Med Dir Assoc. 2007;8:538–40.

    PubMed  Google Scholar 

  108. Mossello E, Pieraccioli MC, Zanieri S, et al. Ambulatory blood pressure monitoring in older nursing home residents: diagnostic and prognostic role. J Am Med Dir Assoc. 2012;13:760.e1–5.

    PubMed  Google Scholar 

Download references

Acknowledgments

No external funds were used in the preparation of this manuscript.

Conflict of interest

The author has no potential conflict of interest that might be relevant to the contents of this article.

Author information

Authors and Affiliations

  1. Divisions of Geriatric Medicine and Endocrinology, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO, 63104, USA

    John E. Morley

Authors
  1. John E. Morley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John E. Morley.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Morley, J.E. Treatment of Hypertension in Older Persons: What Is the Evidence?. Drugs Aging 31, 331–337 (2014). https://doi.org/10.1007/s40266-014-0171-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40266-014-0171-7

Keywords

Search

Navigation