Hypertension in older adults: Assessment, management, and challenges

Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the wo...

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Veröffentlicht in:	Clinical cardiology (Mahwah, N.J.) Jg. 43; H. 2; S. 99 - 107
Hauptverfasser:	Oliveros, Estefania, Patel, Hena, Kyung, Stella, Fugar, Setri, Goldberg, Alan, Madan, Nidhi, Williams, Kim A.
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	New York Wiley Periodicals, Inc 01.02.2020 John Wiley & Sons, Inc
Schlagworte:	Age Age Factors Aged Aged, 80 and over Aging Alzheimer's disease antihypertensive agents Antihypertensive Agents - therapeutic use Blood pressure Blood Pressure - drug effects blood pressure monitoring Cardiology Cardiovascular disease Coronary vessels Frailty geriatrics Health Status Healthy Lifestyle Heart rate Humans Hypertension Hypertension - diagnosis Hypertension - epidemiology Hypertension - physiopathology Hypertension - therapy Meals older adult Older people Patients Physicians Population Practice Guidelines as Topic Pressure measurement Review Reviews Risk Factors Risk Reduction Behavior Treatment Outcome United States > US Europe older adult geriatrics antihypertensive agents hypertension blood pressure monitoring
ISSN:	0160-9289, 1932-8737, 1932-8737
Online-Zugang:	Volltext
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Abstract	Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the world's population by 2025. Adverse outcomes in older adults are compounded by mechanical hemodynamic changes, arterial stiffness, neurohormonal and autonomic dysregulation, and declining renal function. This review highlights the current evidence and summarizes recent guidelines on hypertension, pertaining to older adults. Management strategies for hypertension in older adults must consider the degree of frailty, increasingly complex medical comorbidities, and psycho‐social factors, and must therefore be individualized. Non‐pharmacological lifestyle interventions should be encouraged to mitigate the risk of developing hypertension, and as an adjunctive therapy to reduce the need for medications. Pharmacological therapy with diuretics, renin‐angiotensin system blockers, and calcium channel blockers have all shown benefit on cardiovascular outcomes in older patients. Given the economic and public health burden of hypertension in the United States and globally, it is critical to address lifestyle modifications in younger generations to prevent hypertension with age.
AbstractList	Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the world's population by 2025. Adverse outcomes in older adults are compounded by mechanical hemodynamic changes, arterial stiffness, neurohormonal and autonomic dysregulation, and declining renal function. This review highlights the current evidence and summarizes recent guidelines on hypertension, pertaining to older adults. Management strategies for hypertension in older adults must consider the degree of frailty, increasingly complex medical comorbidities, and psycho‐social factors, and must therefore be individualized. Non‐pharmacological lifestyle interventions should be encouraged to mitigate the risk of developing hypertension, and as an adjunctive therapy to reduce the need for medications. Pharmacological therapy with diuretics, renin‐angiotensin system blockers, and calcium channel blockers have all shown benefit on cardiovascular outcomes in older patients. Given the economic and public health burden of hypertension in the United States and globally, it is critical to address lifestyle modifications in younger generations to prevent hypertension with age. Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the world's population by 2025. Adverse outcomes in older adults are compounded by mechanical hemodynamic changes, arterial stiffness, neurohormonal and autonomic dysregulation, and declining renal function. This review highlights the current evidence and summarizes recent guidelines on hypertension, pertaining to older adults. Management strategies for hypertension in older adults must consider the degree of frailty, increasingly complex medical comorbidities, and psycho-social factors, and must therefore be individualized. Non-pharmacological lifestyle interventions should be encouraged to mitigate the risk of developing hypertension, and as an adjunctive therapy to reduce the need for medications. Pharmacological therapy with diuretics, renin-angiotensin system blockers, and calcium channel blockers have all shown benefit on cardiovascular outcomes in older patients. Given the economic and public health burden of hypertension in the United States and globally, it is critical to address lifestyle modifications in younger generations to prevent hypertension with age.Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the world's population by 2025. Adverse outcomes in older adults are compounded by mechanical hemodynamic changes, arterial stiffness, neurohormonal and autonomic dysregulation, and declining renal function. This review highlights the current evidence and summarizes recent guidelines on hypertension, pertaining to older adults. Management strategies for hypertension in older adults must consider the degree of frailty, increasingly complex medical comorbidities, and psycho-social factors, and must therefore be individualized. Non-pharmacological lifestyle interventions should be encouraged to mitigate the risk of developing hypertension, and as an adjunctive therapy to reduce the need for medications. Pharmacological therapy with diuretics, renin-angiotensin system blockers, and calcium channel blockers have all shown benefit on cardiovascular outcomes in older patients. Given the economic and public health burden of hypertension in the United States and globally, it is critical to address lifestyle modifications in younger generations to prevent hypertension with age.
Author	Goldberg, Alan Williams, Kim A. Fugar, Setri Madan, Nidhi Kyung, Stella Oliveros, Estefania Patel, Hena
AuthorAffiliation	1 Department of Internal Medicine, Division of Cardiology Rush University Medical Center
AuthorAffiliation_xml	– name: 1 Department of Internal Medicine, Division of Cardiology Rush University Medical Center
Author_xml	– sequence: 1 givenname: Estefania orcidid: 0000-0003-1780-1982 surname: Oliveros fullname: Oliveros, Estefania email: estefaniaoliveros@gmail.com organization: Rush University Medical Center – sequence: 2 givenname: Hena surname: Patel fullname: Patel, Hena organization: Rush University Medical Center – sequence: 3 givenname: Stella surname: Kyung fullname: Kyung, Stella organization: Rush University Medical Center – sequence: 4 givenname: Setri surname: Fugar fullname: Fugar, Setri organization: Rush University Medical Center – sequence: 5 givenname: Alan surname: Goldberg fullname: Goldberg, Alan organization: Rush University Medical Center – sequence: 6 givenname: Nidhi surname: Madan fullname: Madan, Nidhi organization: Rush University Medical Center – sequence: 7 givenname: Kim A. surname: Williams fullname: Williams, Kim A. organization: Rush University Medical Center
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/31825114$$D View this record in MEDLINE/PubMed
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Copyright	2019 The Authors. published by Wiley Periodicals, Inc. 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
Copyright_xml	– notice: 2019 The Authors. published by Wiley Periodicals, Inc. – notice: 2019 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. – notice: 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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SubjectTerms	Age Age Factors Aged Aged, 80 and over Aging Alzheimer's disease antihypertensive agents Antihypertensive Agents - therapeutic use Blood pressure Blood Pressure - drug effects blood pressure monitoring Cardiology Cardiovascular disease Coronary vessels Frailty geriatrics Health Status Healthy Lifestyle Heart rate Humans Hypertension Hypertension - diagnosis Hypertension - epidemiology Hypertension - physiopathology Hypertension - therapy Meals older adult Older people Patients Physicians Population Practice Guidelines as Topic Pressure measurement Review Reviews Risk Factors Risk Reduction Behavior Treatment Outcome
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Title	Hypertension in older adults: Assessment, management, and challenges
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