Management of Hypertension in the Elderly Patients: A Systematic Review
Abstract
Hypertension is one of the most common disease but it has adverse effects on target organs such as heart, brain, kidneys, and blood vessels if not treated properly. The management of hypertension could be different in some special population, such as in the elderly. In this population, there are special things to be considered, such as antihypertension drugs choices and blood pressure target. The purpose of this article was to provide information about the current management of hypertension in the elderly. The method used was systematic review with PRISMA protocol. Journal review results concluded that antihypertensive drugs therapy in elderly starts at blood pressure > 140/90 mmHg (130/85 mmHg if there is complication of diabetes, kidney disease,
and cardiovascular); optimum target of systolic blood pressure is 120-140 mmHg and diastolic blood pressure not less than 65 mmHg; antihypertension drugs choices base on comorbidities and patient response to medication, and lifestyle modification is necessary to reduce cardiovascular risk and reduce the amount of drug consumed.
Keywords: hypertension, elderly, management
References
[1] Gordis L. Epidemiology. Fourth Edi. Epidemiology. Philadelphia: Joan Sinclair; 2008. p. 247-265 hal.
[2] Rahajeng E, Tuminah S. Prevalensi Hipertensi dan Determinannya di Indonesia. Maj Kedokt Indonesia. 2009;59(12):580–7.
[3] Health M of. Riset Kesehatan Dasar [Internet]. Jakarta: MoH; 2013. 1-200 hal. Available at: http://labdata. litbang.depkes.go.id/riset-badan-litbangkes/menu-riskesnas/menu-riskesdas/374-rkd-2013
[4] Bandiara R. An Update Management Concept in Hypertension. In Bandung; 2008. hal. 8.
[5] Aronow WS, Fleg JL, Pepine CJ, Artinian NT, Bakris G, Brown AS, et al. ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly. J Am Soc Hypertens [Internet]. 2011;5(4):259– 352. Available at: http://linkinghub.elsevier.com/retrieve/pii/S1933171111001549
[6] Carlberg B, Nilsson PM. Hypertension in the elderly: What is the Goal Blood Pressure Target and How Can this be Attained? Curr Hypertens Rep. 2010;12(5):331–4.
[7] Acelajado MC. Optimal management of hypertension in elderly patients. Integr Blood Press Control [Internet]. 2010;3:145–53. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid= 3172073&tool=pmcentrez&rendertype=abstract
[8] James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 EvidenceBased Guideline for the Management of High Blood Pressure in Adults. Jama [Internet]. 2014;311(5):507. Available at: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2013.284427
[9] Blok CGH, de Ridder M a. J, Verhamme KMC, Moorman PW. Hypertension in Older Patients, A Retrospective Cohort Study. BMC Geriatr [Internet]. 2016;16(1):142. Available at: http://bmcgeriatr. biomedcentral.com/articles/10.1186/s12877-016-0316-0
[10] Moher D. Systematic Reviews and Meta-Analyses: The PRISMA Statement. Annuals of Internal Medicine. 2009;151(4):264–9. Available at: papers2://publication/uuid/8E18828D-1880-40C4-A4CCBD7821A2E97E
[11] Garrett AD. New AHA Guidelines Help Manage Hypertension in The Elderly. Drug Topics. 2012;156(4).
[12] Oliva R V., Bakris GL. Management of Hypertension in the Elderly Population. Journals Gerontol Ser A Biol Sci Med Sci [Internet]. 2012;67(12):1343–51. Available at: https://academic.oup.com/ biogerontology/article-lookup/doi/10.1093/gerona/gls148.
[13] Bulpitt CJ, Beckett NS, Peters R, Leonetti G, Gergova V, Fagard R, et al. Blood pressure control in the Hypertension in the Very Elderly Trial (HYVET). J Hum Hypertens [Internet]. 2012;26(3):157–63. Available at: http://www.nature.com/doifinder/10.1038/jhh.2011.10
[14] Williamson JD, Supiano MA, Applegate WB, Berlowitz DR, Campbell RC, Chertow GM, et al. Intensive vs. Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years. Jama [Internet]. 2016;315(24):2673. Available at: http://jama.jamanetwork.com/article.aspx?doi=10.1001/ jama.2016.7050