TITLE

AN APPROACH TO THE TREATMENT OF HYPERTENSION IN THE AGED

AUTHOR(S)
Fishback, David B.
PUB. DATE
April 1976
SOURCE
Angiology;Apr1976, Vol. 27 Issue 4, p212
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Because of the multiplicity of disease conditions and diminished tolerance for drugs in the aged, it is necessary to know concomitant pathologic conditions to determine which antihypertensive drug to use. In the Philadelphia Geriatric Center, there are about 1,000 residents, between 70 and 100 years of age. About 40% have hypertension; almost 50% have or once had depression; there are many cases of hiatal hernia and/or peptic ulcer; and in one subdivision of residents, almost 40% have renal disease with BUN above 30 mg/100 ml. In antihypertensive treatment, some individuals respond fairly well to reassurance and weight reduction, when obese, even without drugs. All are given a low-salt diet. A diuretic is first used-thiazide in cases of good renal function, furosemide with impaired renal function. Liquid potassium supplements are given. If there is but little reduction in blood pressure in several weeks, methyldopa is added in ascending doses, in cases with or without renal impairment. In hypertension with impaired renal function, furosemide and/or methyldopa were especially valuable. Furosemide as an antihypertensive drug was also noted to delay the onset of congestive heart failure. Since reserpine can aggravate peptic ulcer and can precipitate or aggravate depression, it should seldom be used to treat hypertension in the aged. Guanethidine is rarely used, since it can cause cerebrovascular insufficiency and marked weakness. High blood pressure should be reduced slowly in the aged, to avoid untoward effects. In the Philadelphia Geriatric Center, there are several physicians treating hypertensive residents. I wish to thank the individual doctors of the Philadelphia Geriatric Center whose charts I was able to review, in addition to my own, in order to ascertain their orders and therapy in hypertensive patients-Drs. Morton Ward, the Medical Director; J. J. Cohen, Associate Medical Director; Mitchell A. Selickman; Asher Woldow; Louis Zisserman; and Morton Beck. I also wish to thank the Medical Records Room, Mrs. Lauretto Shore, Director, and her staff, who were of gracious assistance. I am also grateful to Mrs. Mary Morgan, who typed the manuscript.
ACCESSION #
16352817

 

Related Articles

  • Aggressive management of hypertension in elderly urged. Portyansky, Elena // Drug Topics;7/19/99, Vol. 143 Issue 14, p19 

    Deals with issues concerning the treatment of hypertension in elderly patients in the United States. Implications of the findings of a study evaluating the medical treatment of elderly hypertensive patients; How to choose and initiate the initial drug; Evaluation of some alternative treatment...

  • Aggressive treatment of hypertension. Hines, Silvia E. // Patient Care;8/30/2000, Vol. 34 Issue 16, p14 

    Discusses aggressive treatment of hypertension in old age. Cardiovascular risk accompanying isolated systolic hypertension (ISH); New emphasis being placed on controlling ISH in elderly patients; Self-assessment of blood pressure; Renovascular hypertension in patients with new-onset or...

  • When hypertension treatment fails, one drug may be as good as two.  // Geriatrics;Nov95, Vol. 50 Issue 11, p19 

    Discusses the results of a study conducted by the US Department of Veterans Affairs (VA) on the treatment of hypertension in old people. Effectiveness of switching to a different class of drugs when initial antihypertensive therapy fails; Comparison with the effect of using a combination of...

  • New hypertension study refutes ALLHAT.  // Formulary;Mar2003, Vol. 38 Issue 3, p129 

    Cites the study known as the Second Australian National Blood Pressure Study (ANBP2) which refutes the findings from the published Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Superiority of angiotensin converting enzyme inhibitors over diuretics in preventing...

  • Antihypertensive Treatment in Elderly Patients Aged 75 Years or Over: A 24-Week Study of the Tolerability of Candesartan Cilexetil in Relation to Hydrochlorothiazide. Neldam, S.; Forsén, B. // Drugs & Aging;2001, Vol. 18 Issue 3, p225 

    Objective: To assess the safety and tolerability of the AT-receptor blocker candesartan cilexetil in relation to the diuretic hydrochlorothiazide (HCTZ) in elderly patients. Design and setting: A multicentre, double-blind, randomised, parallel group study. 32 general practice centres and 3...

  • EXERCISE AMOUNTS AFFECT BLOOD PRESSURE. Cannon, Joe // Today's Dietitian;Sep2011, Vol. 13 Issue 9, p88 

    The article focuses on the impact of exercise on the blood pressure of hypertensive adults in the U.S. Study shows that postexercise for 60 minutes help reduce the blood pressure of adults which is similar to the observation in middle-aged women on hypertensive treatments after performing three...

  • ACE inhibitors are better than diuretics for treatment of hypertension in the elderly. Frazier, Jenny M.; Kane, Kevin Y. // Journal of Family Practice;Jun2003, Vol. 52 Issue 6, p436 

    Despite similar reductions in blood pressure, angiotensin-converting enzyme (ACE) inhibitors demonstrate lower combined rates of cardiovascular events or all-cause mortality in elderly hypertensive patients compared with diuretics. This benefit is most evident in men. These results may differ...

  • Systolic HT Treatment in Elderly Reduces Mortality.  // Kidney;Jan/Feb99, Vol. 8 Issue 1, p17 

    Discusses the findings of a study which determined whether the benefit of antihypertensive treatment varied according to sex, previous cardiovascular complications, age, initial blood pressure, smoking or drinking. Observation that stepwise antihypertensive treatment improved prognosis in...

  • Hypertension therapy in the older adults-do we know the answers to all the questions? The status after publication of the ACCF/AHA 2011 expert consensus document on hypertension in the elderly. Banach, M; Aronow, W S // Journal of Human Hypertension;Nov2012, Vol. 26 Issue 11, p641 

    The authors discuss on the effective treatment for hypertension (HTN) in the elderly population. The authors say that the Hypertension in the Very Elderly Trial (HYVET) confirmed the inevitability of HTN therapy in elderly patients and the study was ended after a median follow-up of one year and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics