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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Bibliographic Details
Published in:Clinical cardiology (Mahwah, N.J.) Vol. 43; no. 2; pp. 99 - 107
Main Authors: Oliveros, Estefania, Patel, Hena, Kyung, Stella, Fugar, Setri, Goldberg, Alan, Madan, Nidhi, Williams, Kim A.
Format: Journal Article
Language:English
Published: New York Wiley Periodicals, Inc 01.02.2020
John Wiley & Sons, Inc
Subjects:
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 Access:Get full text
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Summary: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.
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ISSN:0160-9289
1932-8737
1932-8737
DOI:10.1002/clc.23303