Hypertension in Older Patients
Hypertension is present in most individuals older than 65 years. Treatment recommendations for patients in this age group are generally the same as for others with hypertension. In older patients with isolated systolic hypertension, the preferred treatment is a diuretic with or without a β-blocker, or a dihydropyridine CCB alone. Diastolic BP less than 75 mm Hg increases these patients’ risk of stroke and should be avoided.
Antihypertensive drug therapy in older patients can cause adverse effects that increase the risk of falls, such as dizziness and hypotension. Appropriate precautions should be taken to reduce this risk and enhance patient safety.
Dementia occurs more commonly in individuals with hypertension. In some patients, antihypertensive therapy may slow the progression of cognitive impairment.
Excerpted from BCSC 2020-2021 series: Section 1 - Update on General Medicine. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.