Manejo de la hipertensión en adultos mayores: un reto clínico actual

Abstract

Hypertension is the most prevalent cardiovascular risk factor worldwide, increasing due to population aging. Poorly controlled hypertension is frequently associated with stroke and coronary disease, among other conditions. This population presents pathophysiological changes related to aging that predispose them to develop hypertension. Likewise, older adults show pharmacokinetic and pharmacodynamic changes that are important to consider when selecting an antihypertensive therapy.

The treatment of hypertension in older patients has shown to be beneficial in terms of mortality and risks of cardiovascular events; however, there is a discrepancy between the goals for the treatment of hypertension in different international guidelines, which causes great uncertainty in the clinical practice, especially in very frail patients or with high comorbidity, since most clinical trial often excluded them.

In conclusion, prescribing a specific antihypertensive therapy in older adults could be a real clinical challenge. It requires a clear clinical judgment considering the patient´s context and comorbidities while selecting pharmacological agents and blood pressure goals.