Peculiaridades del manejo de la hipertensión arterial en el anciano. Documento de consenso de la Sociedad Centroamericana y del Caribe de Hipertensión arterial

Abstract

Arterial hypertension is one of the most prevalent diseases in the field of geriatrics and is also a risk factor for pathologies that frequently result in hospital admissions, such as heart failure and stroke. This article addresses both pharmacological and non-pharmacological diagnosis and treatment strategies, focusing on the role of frailty as a guiding principle in determining the most appropriate course of treatment, emphasizing patient-centred prescribing. Furthermore, the article reviews other frequent topics, such as polypharmacy and orthostatic hypotension. Moreover, a concise overview of the current evidence in geriatrics on ambulatory blood pressure monitoring and self-measurement of blood pressure will be provided. Furthermore, a brief summary of the underlying pathophysiology and current epidemiological trends is provided. This consensus is founded upon the initial premise that a comprehensive geriatric assessment should be conducted to ascertain whether a blood pressure reduction strategy could confer a net benefit for elderly patients while simultaneously avoiding an increase in the safety risks associated with these strategies and preventing a de-prescription due to ageism. This is particularly important given the significance of maintaining optimal blood pressure control to prevent related complications.