Hypertension in the Elderly
In patients with sporadically elevated blood pressure or white coat hypertension, a 24-h ambulatory BP monitoring is useful. This chapter will provide an update in the clinical management of hypertension in the elderly. Most of the causes of secondary hypertension in the younger adult are relatively uncommon in the elderly with the exception of renal artery stenosis. Evaluation of target organ damage begins with a physical examination. Hypertensive retinopathy together with left ventricular hypertrophy and renal impairment are considered as an indicator of target organ damage There is positive evidence that treating hypertension in the elderly and very elderly provides clinical benefits. Several trials have indicated that lowering the systolic blood pressure (SBP) to less than 140 mmHg as recommended by the prevailing guidelines is not upheld by evidence in the elderly and does not benefit the elderly and the very elderly.
KeywordsWhite coat hypertension Isolated systolic hypertension Sodium sensitivity Hypertensive retinopathy Renal artery stenosis
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