Arterial hypertension treatment in elderly

Abstract

It is anticipated that over the next 45 years the global population of the globe will increase from 6 to 9 billion. This increase, however, is not associated with the growth of the birthrate but with increases in life expectancy. This situation leads consequently to an increase in the population percentage of adults and the elderly. The prevalence of hypertension increases with age. According to the guidelines of the Polish Society of Hypertension (PTNT) of 2011 and the guidelines of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) of 2013, criteria for hypertension diagnosis in the elderly are the same as in the general population. There is a consensus in the recommendations for the treatment of hypertension that its primary goal is to reduce total and cardiovascular mortality and risk of major cardiovascular events (myocardial infarction, heart failure, stroke) and renal failure. Following the recommendations of the various societies, the target pressure values in the elderly should be < 140/90 mm Hg. However, the HYVET trial results shed some light on slightly different antihypertensive treatment in the population > 80 years of age. On this basis, it was found that in patients over 80 years old, who are not burdened with multiple comorbidities, antihypertensive therapy should be initiated when SBP > 160 mm Hg. Careful management of these patients shows that the target threshold below which SBP should be reduced is 150 mm Hg. Especially in the elderly, it is very important to individualize the antihypertensive therapy, based i. a. on the clinical condition of the patient.