A Review of Clinical Guidelines and Pharmacotherapeutic Management of Hypertension in Older Adults.

Abstract

OBJECTIVE: To provide an up-to-date review of current hypertension (HTN) guidelines and discuss pharmacotherapeutic management of HTN in the older adult population.<br/> DATA SOURCES: A PubMed search of articles published through June 2018 was performed using a combination of the following words: elderly, older adults, geriatric, and HTN.<br/> STUDY SELECTION/DATA EXTRACTION: Relevant original research, review articles, and guidelines were assessed for the management of HTN in older adults. References from the above literature were also evaluated. Articles were selected for inclusion based on relevance to the topic, detailed methods, complete results, and after a thorough discussion among the authors.<br/> DATA SYNTHESIS: HTN is a common chronic disease state in older adults. Until recently, most guidelines recommended a higher threshold for blood pressure targets in this population, compared with the general adult population. In 2017, two new guidelines for the management of HTN were published, which provided conflicting recommendations for blood pressure goals in the older population. This article reviews current U. S. HTN guidelines published in 2014 to 2017 that most commonly influence patient care, and it specifically addresses the blood pressure targets and pharmacotherapeutic management of HTN in older adults.<br/> CONCLUSION: Management of HTN in older adults is important to avoid further complications and improve outcomes in this population. Blood pressure targets and HTN management should be individualized in older adults based on comorbid conditions, life expectancy, and risk for adverse drug events.