Guidelines for Treating Isolated Systolic Hypertension in the Older Adult

Abstract

This is a comparison of how guidelines from different countries around the world address hypertension in the older adult. A review of literature found, as JNC-8 states, there is not a unanimous opinion on the subject. There is an abundance of research on hypertension, but there remains much to be learned. Hypertensive medications are evolving and the people are living longer lives. With all these variables changing there is not a consensus agreement on the ideal blood pressure or the best medication regimen.

Purpose: The purpose of this article is to compare the latest guidelines for treating isolated systolic hypertension in the elderly, increase provider understanding of the physiology of hypertension in the elderly and improve provider understanding of the latest recommendations.

Data Sources: The latest guidelines produced by Joint National Committee were compared to the most current guidelines from other ‘first world’ countries available on the worldwide web. In additionCumulative Index to Nursing and Allied Health Literature Plus with Full Text, Cochrane Library and Medline with Full text databases were searched for research published between January 2008 and present. Key terms: hypertension, management, blood pressure, isolated systolic blood pressure, elderly and geriatric.

Conclusions: The threshold blood pressure and the goal blood pressure vary between guidelines, but all guidelines recommend treating hypertension in the elderly at all ages. Most guidelines agree to the class of drugs to be used in treatment. The European is the only guideline that continues to recommend beta-blockers to treat hypertension not accompanied by co-morbidities.