Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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Treatment of hypertension in elderly

노인 고혈압의 치료

  • Seung Jae Joo (Division of Cardiology, Department of Internal Medicine, Jeju National University Hospital) ;
  • Dong-Soo Kim (Division of Cardiology, Department of Internal Medicine, Inje University Haeundae Paik Hospital)
  • 주승재 (제주대학교병원 심장내과) ;
  • 김동수 (인제대학교해운대백병원 심장내과)
  • Received : 2022.08.06
  • Accepted : 2022.10.20
  • Published : 2022.12.31
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Abstract

Whereas systolic blood pressure (SBP) continuously rises with age, diastolic blood pressure (DBP) gradually decreases after the age of 55 years. Therefore, hypertension in the elderly shows the pattern of isolated systolic hypertension. There is evidence on the benefits of controlling blood pressure (BP) in elderly patients with hypertension. The BP lowering effect has also been demonstrated in patients over 80 years of age with hypertension. The BP threshold for the initiation of antihypertensive drug treatment for older adults with hypertension is gradually decreasing. The antihypertensive treatment is recommended if, despite therapeutic lifestyle modifications, SBP ≥140 mmHg or DBP ≥90 mmHg in those aged 65-79 years old, and SBP ≥140-160 mmHg or DBP ≥90 mmHg in those aged ≥80 years old. Although there is no consensus on the target BP for older adults with hypertension, a target SBP of <130-140 mmHg and DBP of <80-90 mmHg are recommended. In older adults over 80 years of age with hypertension, the target SBP is <140-150 mmHg. When the dose of antihypertensive drugs is increased to reach the target SBP, DBP may decrease to less than 70 mmHg, but it should not be <60 mmHg. Thiazide diuretics, calcium channel blockers, angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers can be selected as the first-line drug for older adults with hypertension. Beta-blockers may be selected in case of compelling indications.

Keywords

Acknowledgement

이 논문은 2022학년도 제주대학교 교육·연구 및 학생지도비 지원에 의해서 연구되었다.

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