Key result
Intensive BP lowering to the lowest tolerated target provides greater CV protection in elderly patients.
Why the study?
Studies evaluating different blood pressure targets in older patients have yielded mixed results, leaving uncertainty regarding the ideal blood pressure target in this vulnerable population.
Does intensive blood pressure lowering reduce cardiovascular complications in elderly hypertensive patients aged ≥65 years?
Does intensive blood pressure lowering reduce cardiovascular complications in elderly hypertensive patients aged ≥65 years?
Age does not preclude an aggressive strategy for treating hypertension; targeting the lowest well-tolerated blood pressure is recommended for elderly patients.
May support intensive BP targets in elderly hypertensives; leaves open prospective RCT confirmation.
INTRODUCTION: Antihypertensive treatment provides substantial benefits in older people. However, many challenges remain, including the ideal blood pressure (BP) target to be achieved. Because the elderly population is particularly vulnerable to adverse events, BP control should be carefully managed. Some studies have evaluated the cardiovascular effects of different BP targets in older patients, with mixed results and uncertainty about the most appropriate BP target. However, pooled analyses suggest that intensive BP lowering provides greater cardiovascular protection than less intensive strategies in elderly hypertensive patients. AREAS COVERED: Understanding the balance between the risks and benefits of intensive BP targets and individualizing treatment is essential to ensure that older patients receive appropriate treatment to reduce the risk of cardiovascular complications. We reviewed data from clinical trials which investigated the protective effects of BP lowering drugs in elderly hypertensive patients aged ≥65 years. EXPERT OPINION: Evidence suggests that age does not preclude an aggressive strategy for treating hypertension in elderly patients. Being 'tolerant' with one hand and 'intensive' with the other should become a universal standard in the management of elderly hypertensive patients. The lowest well-tolerated BP could be a simple and universally applicable BP target in the management of hypertensive patients, including the elderly.
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Angeli et al. (2024) conducted a review in Hypertension. Intensive BP lowering vs. Less intensive strategies was evaluated. Intensive blood pressure lowering to the lowest well-tolerated target provides greater cardiovascular protection than less intensive strategies in elderly hypertensive patients aged ≥65 years.
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