Key result
Current evidence suggests that an appropriate blood pressure goal may be somewhat higher in octogenarians and that thiazide diuretics may be the initial treatment of choice.
Why the study?
What are the appropriate blood pressure goals and treatment options for hypertension in octogenarians?
What are the appropriate blood pressure goals and treatment options for hypertension in octogenarians?
This review highlights the lack of specific evidence for treating hypertension in octogenarians and suggests that slightly higher blood pressure goals (e.g., 150/80 mm Hg) may be appropriate.
Answers are grounded in this paper and cite their sources.
Supports higher BP targets with thiazides first in octogenarians; leaves open optimal strategy pending dedicated RCTs.
One quarter of Americans will be older than 80 by 2030, and hypertension in this group will be ubiquitous. Most studies of hypertension exclude octogenarians and are not able to be generalized because of differences in physiologic and social phenomena. This review evaluates the existing literature in an effort to identify unresolved issues and guide future areas of investigation. Hypertension has been well characterized in adults and the young elderly, and the focus is on optimizing treatment regimens. However, research specifically involving this rapidly growing minority is sparse. Most studies are still trying to characterize blood pressure goals, and only one major series has begun to evaluate treatment options. Based on available evidence, it appears that an appropriate blood pressure goal may be somewhat higher in octogenarians and that thiazide diuretics may be the initial treatment of choice.
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Tabriziani et al. (2012) conducted a review in Hypertension. Antihypertensive therapy was evaluated. Current evidence suggests that an appropriate blood pressure goal may be somewhat higher in octogenarians and that thiazide diuretics may be the initial treatment of choice.
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