What are important considerations in treating hypertension in the elderly?
BP reduction should always be gradual in elderly patients.
All patients should receive nonpharmacological therapy, particularly dietary salt restriction and weight loss in patients who are obese. Drug therapy should be started if lifestyle changes are not sufficient.
A potential limiting factor to the use of antihypertensive drugs is orthostatic (postural) and/or postprandial hypotension, common symptoms among elderly patients with hypertension. A long-acting dihydropyridine or a thiazide diuretic is generally preferred in elderly patients because of increased efficacy in blood pressure lowering.