Should Hypertension Treatment Intensify with Age?

In a feasibility study, targeting antihypertensive treatment to 130/80 mm Hg rather than 140/85 mm Hg significantly increased cerebral blood flow in elderly patients.

Hypertension leads to reduced cerebral blood flow (CBF), which is associated with cognitive decline. However, aggressive blood pressure (BP) reduction in the elderly may produce cerebral hypoperfusion, resulting in falls and, possibly, stroke. In a proof-of-concept study, investigators recruited 37 primary-care patients aged ≥70 with uncontrolled clinical hypertension (defined as a systolic BP of >150 mm Hg as averaged from the second and third of 3 sitting measurements) while taking ≤1 antihypertensive medication. Patients were randomized to receive protocol-defined antihypertensive treatment to a target BP lower than either 130/80 mm Hg (intensive) or 140/85 mm Hg (usual). Magnetic resonance imaging to measure CBF and 24-hour ambulatory B…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Should Hypertension Treatment Intensify with Age?

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Reviewing Author