Key result
Managing blood pressure in elderly patients with frailty, orthostatic hypotension, and resistant hypertension requires tailored drug choices, blood pressure targets, and shared decision-making.
Why the study?
Treating hypertension in the elderly is challenging due to frailty, orthostatic hypotension, and resistant hypertension, which increase susceptibility to treatment-related adverse events.
How should blood pressure targets and medications be managed in elderly patients with hypertension complicated by frailty, orthostatic hypotension, or resistant hypertension?
How should blood pressure targets and medications be managed in elderly patients with hypertension complicated by frailty, orthostatic hypotension, or resistant hypertension?
Tailoring blood pressure targets and medication choices, while incorporating frailty assessments and shared decision-making, is essential for safely managing hypertension in complex elderly patients.
Tailored BP strategies may aid frail elderly with comorbidities; leaves open optimal targets from prospective trials.
Hypertension increases the risk of cardiovascular disease in the elderly. Although treating hypertension can reduce the risk of cardiovascular disease and its related mortality, it is also challenging because these patients could have frailty, orthostatic hypotension (OH) and resistant hypertension (RHTN), which makes them more susceptible to treatment-related adverse events. Identifying such patients and tailoring the choice of drugs and blood pressure targets is crucial to balance the harms and benefits. The Clinical Frailty Scale is recommended to assess elderly patients with hypertension and frailty. For very frail patients, unnecessary medications should be deprescribed to avoid adverse events. Hypertension and OH frequently co-occur in the elderly, and recognizing and managing OH is essential to prevent falls and adverse events. The management of blood pressure in elderly patients with frailty, OH, and RHTN is complex, requiring the patients, their family and caregivers to be involved in decision-making to ensure that treatment plans are well-informed and aligned with the patient's needs.
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Wu et al. (2024) conducted a review in Elderly hypertension, frailty, orthostatic hypotension, and resistant hypertension. Blood pressure management was evaluated. Managing blood pressure in elderly patients with frailty, orthostatic hypotension, and resistant hypertension requires tailored drug choices, blood pressure targets, and shared decision-making.
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