Therapeutic policy for elderly hypertensives in Japan--a questionnaire survey of specialists

Abstract

In order to clarify the therapeutic policy for hypertension in the elderly, we mailed a questionnaire to 147 specialists in Japan and received 123 replies. The upper age limit for antihypertensive treatment was considered to be 80-85 years old by about 50% of the specialists, but the other 50% did not consider an upper age limit. The range of the systolic blood pressure (BP) for which drug treatment was indicated in those without cardiovascular complications was considered to be increased with age, being 160 mmHg and higher in those aged 60-69, 160-170 mmHg and higher in those aged 70-79, and 170-180 mmHg and higher in those aged 80-89, while the level of diastolic BP requiring treatment was considered to be 90-95 mmHg and higher in all age ranges. The goal of BP control was considered to be less than 150/90 mmHg in those aged 60-69, and less than 160/90 mmHg in those aged 70-79 by the majority of the specialists, and to be higher in those aged 80-90, i.e. less than 170-180/95-100 mmHg by more than 20% of the specialists. As the initial selection of antihypertensive regimen, calcium antagonists followed by angiotensin I-converting enzyme inhibitors (ACEI) were selected by the majority, while diuretics, beta-blockers and alpha 1 blockers were chosen by the minority.(ABSTRACT TRUNCATED AT 250 WORDS)