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Colegio de Medicina Interna de México.

2023, Number 1

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Med Int Mex 2023; 39 (1)

Systemic high blood pressure in the geriatric patient

Arellano-Navarro CE, Pérez-García CC, Martínez-Gallardo L, León ÁKG, Arriaga-García RJP

Language: Spanish
References: 25
Page: 91-98
PDF size: 228.09 Kb.


ABSTRACT

Cardiovascular diseases are the leading cause of death worldwide. Systemic arterial hypertension is directly related to half of deaths from cardiovascular complications. The pathophysiology of hypertension is special in the elderly, which added to the multiple comorbidities and geriatric syndromes of each individual, makes the diagnosis and treatment of this disease complex and difficult to generalize. This complexity is reflected in the controversy in the literature regarding blood pressure levels that are adequate for an older adult. The purpose of this review is to facilitate the physician decision-making process in the diagnosis, the optimal goals of control for the robust and frail patient, and the selection of pharmacological and non-pharmacological treatment, through a critical analysis that comprises available evidence in the literature that includes geriatric population, such as the Sprint senior study, the Hyvet study, the ESC/ESH 2018 Guide on the diagnosis and treatment of arterial hypertension and the Guide for prevention, detection, evaluation and management of arterial hypertension of the American College of Cardiology. Strict blood pressure control reduces some cardiovascular complications in geriatric patients; however, it can be associated with cognitive impairment and kidney injury, which results in a decline in patient’s functionality and quality of life. Therefore, it is important that our first goal in treatment is to avoid adverse effects: first do no harm.


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