Blood Pressure Treatment in the Elderly

With heart disease and stroke listed among the most deadly health conditions, many people are concerned about keeping a healthy blood pressure to defend against these potentially catastrophic conditions. However, according to MedicineNet.com, the elderly are often not treated for high blood pressure (hypertension) for various reasons. This may be misguided, as there is evidence they should be treated in very specific ways.

Misconception

• Two out of three people over 75 years of age suffer from hypertension, according to MedicineNet.com. However, the idea that a normal systolic blood pressure is "100 plus your age" keeps these conditions from being treated at all. The 100-plus-your-age rule is a common misconception, especially for older people, as it would mean that a normal systolic blood pressure for a 75-year-old is 175--and this is simply not true.

  According to MedicineNet.com, treatment of these conditions with blood pressure-lowering medications reduces the risk of heart failure and stroke by 35 percent, and other cardiovascular conditions by 20 percent.

Reduce Blood Pressure Slowly

• According to the American Heart Association (AHA), blood pressure in the elderly should be reduced slowly and cautiously. Lifestyle changes such as weight reduction, exercise and heart-healthy dieting should be implemented first before drugs are administered.

  When the decision is made to begin dosage of anti-hypertension drugs, the AHA recommends using smaller than normal doses to begin treatment so the change in blood pressure will be gradual.

Salt and Alcohol

• The AHA recommends that elderly people with hypertension should consume no more than 2.3 g of sodium per day to control blood pressure. Check with a doctor before making a drastic cut in salt intake, as other medical conditions could make this change less desirable.

  Alcohol intake should also be limited to no more than two glasses of wine, two beers or two shots of whiskey per day.

Special Considerations

• It is important to note that adverse reactions to prescription drugs in the elderly tend to happen two to three times more often than in younger patients, according to the AHA. Also, knowing a complete medical history is essential is successful treatment.

  Since older people tend to have more pre-existing conditions, it could mean the prescribed drugs have a higher likelihood of interfering with the condition or the medications prescribed for them.

Types of Effective Medication

• The good news is that virtually all blood pressure-lowering medication works basically the same on the elderly as it does on younger patients.

  A study by the Department of Veterans Affairs showed that diltiazem and hydrochlorothiazide were the most effective hypertension drugs used by a group of African-American patients over 60, while atenolol and diltiazem proved to be most effective in white patients over 60, according to the AHA.