Considerations about treatment programs of elderly patients with hypertension

Abstract

Hypertension in elderly patients is a common and frequent disease which could cause stroke, heart failure and renal dysfunction. The pathogenesis of hypertension in the elderly is different from that in the young and middle-aged people, and its clinical characteristics including frequent isolated systolic hypertension, variable blood pressure, high pulse pressure, multiple complications, serious target organ damage, and so on. High prevalence, disability and mortality rates and low awareness, treatment and control rates are prominent phenomena in the elderly patients with hypertension, bringing many difficulties for clinical treatment. Presently, drug therapies for elderly patients mainly include Western medicine (WM), traditional Chinese medicine (TCM), and integrated traditional Chinese and Western medicine. WM therapy has superiority in lowering blood pressure intensively with clear mechanism, but has more adverse reactions. The effects of TCM therapy are multilinked, and TCM is good at reducing side effects and improving symptoms, but TCM preparation falls behind and its hypotensive effects are weak and slow. Furthermore, more multicenter, randomized, controlled and double-blinded clinical trials with large sample are needed to identify the effects of TCM therapy. Based on combination of TCM syndrome differentiation and WM disease differentiation, treatment programs of integrated traditional Chinese and Western medicine would take advantages of both TCM and WM treatment modalities, and are worthy of being studied in the future.