Rational antihypertensive therapy of older patients

Abstract

The article is devoted to the consideration of hypertensive older patients management with accent on pharmacological treatment. For justification of the choice of antihypertensive drugs on the principles of the evidence-based medicine the results of a randomized controlled clinical trials with inclusion of the old and older hypertensive patients are shown. Асcording to published systematic reviews and meta-analysis in comparative aspects are given the effects of different antihypertensive drugs related to their influence on cardiovascular events in this category of patients. Recommendations of rational pharmacotherapy of hypertension relevant to age-specific features of patients are taken with variant positions according to suggestions of leading experts and international organizations – the European Society of Cardiology; the European Society of Hypertension; American Society of Hypertension; the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the Management of Hypertension in Very Old, Frail Subjects; Canadian Hypertension Education Program; the American College of Physicians and the American Academy of Family Physicians; National Institute for Health and Clinical Excellence. The tactic of treatment of geriatric patients with hypertension is summarized.