Nutrition and diet 

Hypertension in the elderly: what treatment tactics to choose

Every day, more and more scientific research evidence confirms the significant benefits of treating hypertension in the elderly. Moreover, the positive effect in patients over the age of 65 is not lower than in those of younger age. The most recent research data is now available (2011) showing that treatment of hypertension has a positive effect even in people 80 years of age and older. Therefore, blood pressure medications should be continued or started in this age group. It is advisable to start with one drug therapy and add a second drug as needed. The decision to start taking pills for an elderly hypertensive patient should be made in conjunction with a doctor individually in each case, and the patient's condition should be carefully examined during and after the phase of selection of treatment.

Read about the treatment of diseases associated with hypertension:

Elderly patients are often unwilling or unable to change their lifestyle. Even if they can quit smoking, improve their diets, and move more, many of them still need to take antihypertensive medications to keep their blood pressure at a level where additional diseases do not develop.

Experts in the treatment of hypertension do not support the hypothesis that different classes of drugs for hypertension differ significantly in their ability to lower blood pressure and protect the heart and blood vessels in young and elderly patients. Thus, the age of the patient should not have a decisive influence on the choice of the drug. Thiazide diuretics, ACE inhibitors, calcium antagonists, angiotensin II receptor blockers, and beta-blockers can be used in older patients for initial and maintenance therapy.

Prescribing drugs for hypertension in elderly patients has the following features:

  • An elderly person must definitely take medication if the systolic pressure is 160 mm Hg. Art. and higher. Zone from 140 to 160 mm Hg. Art. called the "gray" area. In elderly people with blood pressure below 160, in whom hypertension is uncomplicated, treatment does not give significant results. However, if the heart or blood vessels are damaged, then the pressure is between 140 and 160 mm Hg. Art. need to be lowered with medication.
  • Drug treatment should be continued throughout the patient's life, regardless of his age. You should also choose drugs with minimal side effects.
  • A number of other circumstances, such as a stroke or diabetes, determine the choice of drugs for the treatment of hypertension.
  • For convenience, it is preferable to choose a drug that can be taken once a day.
  • An elderly person should start with only half the normal dose of the hypertension medication. Increase the dose gradually to allow the patient to adapt to the drug.
  • Make sure that the elderly patient can open the medicine bottle on their own and knows how to take it. People with arthritis and / or visual impairments are unable to open some forms of packages.
  • Drug interactions are a major potential problem as older people generally take several, and sometimes many, drugs at the same time.

Is it really advisable to treat hypertension in the elderly?

We present to your attention the data of the placebo-controlled study SHEP (Sistolic hypertension in the Elderly Program) in 1997, which involved a large group of 4376 patients aged 60 years and older with isolated systolic hypertension (“upper” blood pressure> 160 mm Hg. Art.). For initial therapy, it was used at a dose of 12.5-25 mg / day. The diuretic was added as needed. During the observation period (average 4.5 years), the risk of developing a cerebral stroke decreased by 36% compared to the control group. The risk of developing coronary heart disease decreased by 27%.

Another study, Systolic hypertension in Europa, enrolled 4695 patients aged 60 years or older with isolated systolic hypertension. Patients received calcium antagonist nitrendipine (10-40 mg per day). This therapy reduced the risk of stroke by an average of 42% and myocardial infarction by 30%. In 1999, they investigated the effectiveness of lowering blood pressure in very elderly people (over 80 years old).

The results of 7 studies were also analyzed, which constituted a group of 1670 patients aged 80 to 99 years (76% of women) with an average blood pressure of 180/80 mm Hg. Art. The follow-up period was 3.5 years. Analysis confirmed that in patients over 80 years of age, it is advisable to carry out drug treatment of hypertension. The incidence of strokes decreased by 34% compared with the group of patients who did not receive treatment. Finally, we refer to the 1991 STOP-Hypertension study, which demonstrated the beneficial effect of hypertension therapy in patients over 60 years of age in Sweden.

A decrease in the number of side, toxic effects is achieved by the appointment of reduced (!) Doses of all drugs and a slower, gradual course of treatment. Of course, elderly patients with hypertension need systematic medical supervision and blood pressure control (nursing care). The principle "do no harm" is most relevant when organizing the treatment of hypertension in the elderly and old people.

  1. Elena Stefanyuk

    The article seems to be written for doctors, but in fact it is intended for hypertensive patients themselves and especially for relatives of elderly patients. Should the patient himself delve into the professional issues of prescribing drugs for hypertension or just trust the doctor? This is a philosophical question :).

  2. Valentine

    Yes, hypertension is dangerous. I have suffered from it for a long time with varying degrees of success. But, I noticed that when you are distracted by something, the pressure is not so felt.

  3. Svetlana

    Hello. A very useful site. My grandmother is 82 years old, suffered a heart attack, but she did not feel it, only a cardiogram showed that she had a heart attack. I was in the hospital for 3 weeks. Now she is taking medications for the heart at home. She suffers from hypertension, she is gone during the day, and rises to 180-100 at night. Observed by a doctor, but nothing helps.

  4. TATIANA

    I AM 62, GROWTH 158, WEIGHT 82. had high blood pressure, which I easily knocked down with andipal, enap, adelfan. But on November 15, 12, the pressure rose suddenly in the morning 230 * 100. Called an ambulance. For some reason, the doctor began to inject chloride intravenously to to reduce, then to make magnesia. called the doctor at home. so she prescribed me very strong ones: orifon, valz, prestarium. my pressure dropped sharply. a few days later it repeated, another ambulance arrived, the doctor gave me some kind of pill under the tongue , and my blood pressure immediately dropped, then they made magnesia. Question: what is this pill and can it be bought at the pharmacy so as not to call an ambulance

  5. Yuliya

    Good afternoon. Thank you very much for the useful information. I would like to clarify about mine specifically (i.e. the case of my mother).
    My mother is 63 years old, height 160 cm, weight about 80 kg. She has hypertension, but apparently cannot pick up pills, her blood pressure often rises to 200 and above. The last time an ambulance was called 3 times at intervals of 2-3 hours. They made all the injections, and after 2-3 hours they were again high. What advice would you give her? But I read your recommendations, but you should use them with caution for those who have kidney problems. I do not know what kind of diagnosis it is, but my mother has for a long time increased creatinine by almost 2 times, but the doctors do not diagnose anything except diabetes mellitus. Please tell me what to do? Thank you very much in advance

  6. Maria

    Hello, tell me, is it possible to take VALZ if the gallbladder has been removed? there in the annotation is written contraindications "Liver dysfunction associated with obstruction of the biliary tract (including biliary cirrhosis, cholestasis)."
    Age 82, height 160, weight 78. Takes VALZ, atenolol, captopril, nifedipine (if the pressure is high). Enalapril canceled? nr it cannot be combined with VALZ. And the pressure jumps from 120 to 170 with a lower 90-100.

  7. Natalia

    I am 56 years old, height 168 cm, weight 98 kg. Hypertension since 2011, there are crises once a year. I take Lodoz, amlodipine, cardiomagnyl, hypotysin, additionally magne-B6 2 times a day. Sugar is normal, cholesterol is normal. Do I take a lot of medications? Removed bilious.

  8. Galina

    Hello, your site is a godsend for those who want to live!
    I ordered it according to the instructions you offered, and I take magnesium, vitamins of group B, omega-3, Q10 for 2 months. taurine and arginine. By distributing in this way;
    in the morning on an empty stomach taurine; after 2 hours in the breakfast area magnesium + B6; omega 3 for lunch; around dinner Q10 and after 2 hours arginine. Correct my scheme, on the site I did not find an interconnection of saving additives, I accept it according to the average rates recommended in the corresponding article on your site, adjust the amount of additives.
    For 2 months of taking supplements, I did not notice any changes in my state of health, they did not affect my hypertension.
    Passed tests in an independent laboratory:
    Glycated hemoglobin 5.8%, height 160 cm, weight 70 kg. I realize that I have crossed the line.
    Creatinine (blood) 89 μmol / l, glomerular filtration rate 53 (according to the formula from the website)
    Triglycerides 0.72 μmol / L
    Cholesterol 4.39 μmol / L
    HDL cholesterol 1.49 μmol / l
    Friedwald LDL cholesterol 2.57 Atherogenic coefficient 1.9 Cholesterol is ok!
    C-reactive protein 4.9 mg / l
    T4 free 14.5 μmol / l
    TSH 4.5 mU / l
    Homocysteine ​​14.40 μmol / L
    Lipoprotein (a) 0.08 g / L
    Albumin (urine)< 0.7 мг/сут
    Creatinine (urine) 3.2 mmol / day The albumin / creatinine ratio 0.2 confuses me with the scantiness of the indicator when the norm is "less than 3.5" Considering that the glomerular filtration rate 53, assess the level of "anxiety of the situation"
    Unfortunately, I am 76 years old, but I lead an active lifestyle, not stubborn, and not harmful, I really need those close to me (from their words, constantly supported by actions that prove these words).
    40 years passionate about family-scale beekeeping

    I have been conducting medication against blood pressure for 25 years, over the past 10 years I have been taking it on the recommendations of doctors (well, you can’t meet the only one competent whom you believe and girlfriends polls don’t help, and on the Internet I haven’t learned how to separate the wheat from the capital of the Udmurt Republic, I think, in Moscow and St. Petersburg it is easier to find a doctor when you want to live. In recent years I have tried to live for 2-3 months with Diovan, Atacand, Mikardis, Normodipin, Norvian, but they could not cope with my pressure. Now (four years) the pressure keeps the cordaflex at night, in the afternoon egilok. But against this background in the morning 170 to 90 In the afternoon 140 to 70
    And in the evening, the stubborn figure again about 170 to 95 awaits CORDAFLEX, and sometimes 180 happens with a tail against the background of complete external well-being. Kapoten was saving me these minutes, but after reading your articles, I will try fiziotens.
    I am worried about the pulse rate (75) and sometimes the occasional "floundering and somersaults" of the heart (ECG within the age norms). Calms the floundering and reduces the heart rate to 65 EGILOK. I know that CORDAFLEX contributes to tachycardia ... lydia shatrova

    Hello, I am 70 years old, I have been ill for a long time, more than 30 years. Now I am treating according to the following scheme - indapamide, carvedilol on an empty stomach in the morning, amlodipine in the afternoon, carvedilol again in the evening. So I was treated for 3 years, but now hemoglobin began to decrease, general weakness. During a consultation with an endocrinologist, she was diagnosed with hypothyroidism and prescribed hormones. At first, the condition seemed to have improved a little, but now everything has begun anew. I removed indapamide and reduced carvedilol, removed amlodipine. While the pressure in the morning is 150/90, but at night it rose to 170/90. I drank Corvalol - it helped. In the morning 140 \ 90. But I'm afraid it won't be for long. The body uses the reserves of carvedilol - and there may be a crisis. The whole problem is that I live in a village and it is not always possible to consult qualified doctors. A big request for advice, maybe you can switch to a different regimen with drugs that have less side effects. I will be very grateful.

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Hypertension is a persistent increase in blood pressure that is diagnosed in all age groups and is the most common disease of the cardiovascular system. Given the widespread occurrence of pathology, the presence of severe complications that cause disability or death of the patient, one of the priority areas of medical science can be called the development of drugs designed to reduce blood pressure.

Treatment of hypertension in the elderly is not an easy task due to the presence of concomitant chronic diseases, problems of drug compatibility, the peculiarity of the pharmacodynamics of drugs in the body (metabolism, absorption, excretion), and their side effects.

High blood pressure in the elderly is a protective adaptive response of the body aimed at ensuring optimal blood supply to all tissues. The heart makes great efforts to push blood through the altered vessels. Their tone decreases with age, elasticity decreases, the lumen narrows due to cholesterol plaques. Renin production by the kidneys decreases, which regulates pressure, and the adrenal hormone aldosterone, on the contrary, increases activity, which leads to the retention of sodium in the body. The latter captures fluid, due to which the volume of circulating blood increases and, as a result, blood pressure rises.

The main goal of treating hypertension in the elderly is to prevent complications such as strokes, heart attacks, and to improve the patient's quality of life.

Pressure readings are usually measured in millimeters of mercury.

The upper level is called the systolic. In the phase of contraction of the ventricles of the heart (systole), blood enters the vessels. The resistance they put up to blood flow is called systolic pressure. The norm is in the range of 100-140 mm Hg.

Diastolic lower pressure corresponds to the phase of relaxation of the myocardium - diastole - and is equal to 70–80 mm Hg.

Normal blood pressure parameters in the elderly:

  • 60-70 years - 130/80 mm Hg,
  • 70-80 years - 140/85 mm Hg,
  • 80–90 years - 140/90 mm Hg.

The diagnostic criterion for hypertension in persons over 60 years old is an indicator above 155/95 mm Hg.

Factors contributing to the development of hypertension in old age:

  1. Decreased adrenal hormone aldosterone.
  2. Atherosclerotic plaques on the walls of blood vessels.
  3. Decreased elasticity of the arteries.
  4. Tissue hypoxia.
  5. Change in rheological properties (fluidity) of blood.
  6. Obesity.
  7. Metabolic syndrome.
  8. Menopause in women.
  9. Bad habits (alcohol, smoking).
  10. Wrong lifestyle (physical inactivity).

Main symptoms and complaints

As a chronic disease, hypertension goes through several stages in the development:

Stage 1 is the easiest. It often proceeds without pronounced symptoms. The pressure is 160/90 mm Hg, it rises periodically.

Stage 2 - moderate. The indicator is kept within 180/100 mm of mercury for a long time.

Stage 3 - Severe. The level is above 180/100 mm Hg and remains at these figures without decreasing.

A feature of the course of hypertension in the elderly is the absence of characteristic symptoms in the first two stages. Complaints in patients appear when the pathological process affects the target organs that are most sensitive to surges in blood pressure: the brain, heart, kidneys.

Action on the central nervous system:

  1. Pain in the back of the head, throbbing and heaviness in the head, dizziness, tinnitus.
  2. Memory impairment, weakness.
  3. Double vision.
  4. Sleep disorder.
  5. Hand tremor.

Action on the heart:

  1. Increased heartbeat.
  2. Dyspnea at first on exertion, later at rest.
  3. Swelling of feet and hands.
  4. Paresthesias, numbness of the limbs.
  5. Pain in the region of the heart.

Action on the kidneys:

  1. Puffiness of the face, nausea.
  2. The accumulation of fluid in the body.
  3. Dysuric disorders.
  4. Back pain.

In severe cases, as a result of persistent angiospasm, flies and flashes of light before the eyes, decreased visual acuity, and retinal hemorrhages are possible.

When the disease affects the internal organs, symptoms of cerebral, coronary, and renal circulation disorders appear. At this stage, the risk of developing strokes, heart attacks, kidney and heart failure increases.

Drug overview

The complexity and tactics of choosing antihypertensive drugs is limited by side effects. The ongoing studies of the tolerability of drug therapy, the number and nature of side effects have proven the effectiveness of the treatment of arterial hypertension in the elderly. Strokes are reduced by 30%, complications from the cardiovascular system by 40%.

A decrease in the side effects of drugs in the treatment of hypertension in an elderly person is achieved by reducing the average dose of the drug with a gradual increase in it until a therapeutic effect is obtained, as well as by dynamic pressure control.

Treatment of hypertension in an elderly person begins with the use of diuretics (diuretics).


This is a group of drugs that have different chemical structures, but combined the ability to remove excess fluid from the body.

The mechanism of action of diuretics:

  1. Water-electrolyte metabolism is normalized.
  2. Decreases the amount of intravascular fluid.
  3. Weaken the susceptibility of arterial walls to the action of hormones.

Their use facilitates the work of the heart, lowers blood pressure, and reduces the risk of complications.

Thiazide group

For hypertension, diuretics, benzothiadiazine derivatives, are usually prescribed:

  1. "Indapamide"
  2. "Dichlothiazide",
  3. "Klopamid"
  4. "Indal",
  5. "Metalozon".

Diuretics of this group have a long, moderate effect. They are well absorbed from the gastrointestinal tract, have high bioavailability, and have a direct effect on the vascular wall. In case of hypertension, it is prescribed daily, used for a long time in small doses.

Side effect - electrolyte disturbances, when the excretion of potassium and magnesium increases, the level of urea rises. A decrease in the amount of sodium leads to dehydration of the body.


Loop diuretics

Got the name for the site of action on the renal tubules in the form of a loop:

  1. "Ethacrynic acid"
  2. "Furosemide"
  3. "Pyretanides"
  4. "Bumetanid".
  1. Expand the venous bed.
  2. Reduce pressure in the left ventricle.
  3. Increases blood flow to the kidneys.
  4. Enhances glomerular filtration.

Pharmacokinetics

Well absorbed in the gastrointestinal tract, metabolized in the liver.

Due to the pronounced, but short action, they are not used for long-term treatment of high blood pressure. They are prescribed for hypertensive crisis and with insufficient effectiveness of other diuretics.

Side effects:

  1. Hypokalemia.
  2. Arrhythmia - in patients receiving cardiac glycosides.
  3. Increases urea and sugar levels.
  4. Paresthesia (sensitivity disorder).
  5. In the blood - thrombocytopenia, agranulocytosis.
  6. Disorders in the gastrointestinal tract.


Beta blockers

One of the oldest drugs used since the 60s of the last century in the treatment of hypertension.

The new 3rd generation includes:

  1. "Labetalol",
  2. "Carvedilol"
  3. "Peliprolol",
  4. Nebivalol.

When using them, the negative influence of the autonomic nervous system on the work of the heart is removed, the need for oxygen decreases, and the peripheral vascular tone weakens.

For elderly patients, diuretics are preferable, but if there are heart problems (ischemia or myocardial infarction), then beta-blockers are included in the complex therapy of hypertension.

Side effect:

  1. Bronchospasm.
  2. Erectile dysfunction in men.
  3. Hypoglycemia.
  4. Bradycardia.
  5. Allergic dermatitis.

Use with caution in bronchial asthma, diabetes mellitus.


ACE inhibitors

The mechanism of action of ACE (angiotensin converting enzyme) is to block an enzyme that stimulates the production of active angiotensin, which causes hypertension.

  1. "Spirapril"
  2. "Enalapril"
  3. Fozinopril.

Action:

  1. The peripheral resistance of the vascular walls decreases.
  2. Improves blood flow in the cerebral, coronary, renal arteries.
  3. The risk of developing arrhythmias is reduced.

The initial dosage of the drug is selected individually by experience. Treatment should be started with a minimum dose, gradually increasing it until the desired effect is obtained. Dosage adjustments are allowed under pressure control. In old age, it is rarely prescribed as a monopreparation. Good results are obtained when using a regimen of ACE hypertension with beta-blockers and diuretics.

The drug has a number of negative side effects - from low blood pressure to allergic reactions, but with the correct and competent selection of the dose, the risk of their development is minimal.


Calcium antagonists

Medicines that inhibit the penetration of calcium ions into the cells of the heart and blood vessels. Due to the increased calcium content in these structures, the sensitivity to the action of hormones increases, their increased reduction occurs, thereby increasing blood pressure.

The effect of this group of drugs is somewhat weaker than that of other antihypertensive drugs, but they reduce the risk of stroke to a greater extent than diuretics and beta-blockers.

  1. Falipamil
  2. "Tiropamil"
  3. Diltiazem,
  4. Amlodipine.

Calcium antagonists should not be prescribed for heart disease.

Side effects: violation of intraventricular conduction, tachycardia, bradycardia.

Other

In addition to the basic drugs used in the treatment of hypertension in elderly patients, folk methods have gained wide popularity.

A prerequisite for using folk remedies is to take a medication that keeps pressure within the age norm.

  1. In the absence of diabetes mellitus, course treatment with grape juice is allowed: daily 200 ml three times a day.
  2. Place a tablespoon of chopped mulberry bark in a saucepan with 500 ml of water. Bring to a boil, insist, strain. Drink during the day between meals.
  3. 200 g of honey, 200 g of dried apricots, medium lemon, chopped in a blender, 200 g of walnuts mix together. Consume a tablespoon half an hour before meals.
  4. Leave the freshly squeezed beetroot juice in the refrigerator for 2 hours. For use, mix with boiled water in a 1: 1 ratio. Drink 100 g daily.


Rehabilitation is indicated in cardiological sanatoriums. For elderly patients, there are restrictions on the choice of a place of rest: it is suitable to stay in a sanatorium of the usual climatic zone in a cold season.

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Treatment of hypertension in the elderly is a complex and highly individualized process that requires a thorough approach using all possible therapeutic agents. People in old age are much more likely to face the manifestation of a disease such as hypertension. This is due to natural age-related changes in the vascular tissue of the circulatory system and the presence of concomitant diseases that were acquired during many years of life. Drug treatment of hypertension in the elderly involves not only the use of potent drugs from the category of diuretics that lower blood pressure and relieve vasospasm, but also requires a number of preventive measures, an annual sanatorium recovery of the body. In addition, traditional medicine is used, acting as an auxiliary element in the general scheme of treatment of arterial hypertension in men and women over 60 years of age. Let us consider in as much detail as possible all the possible features of the therapy of hypertension in elderly people, determine the risk factors, and also study the pharmacological properties of medications that are advisable to use to combat high blood pressure.

Ways to Effectively Treat Hypertension in the Elderly

Medical methods of treating hypertension, regardless of the stage of its development, do not stand still and are constantly being improved. Thanks to this, the elderly have a wide range of various methods and techniques for the treatment of hypertension, its prevention and effective control of the pressure level within 120 to 80 units of the tonometer index. There are the following ways to deal with hypertension in older people:

This method of treating hypertension in old age involves the selection of medicines, the pharmacological properties of which affect exclusively organs and tissues related to the cardiovascular system. These include diuretics, beta-blockers, alpha-blockers, ACF inhibitors. The intended purpose of these drugs is to lower blood pressure in the event of a hypertensive crisis in a patient and to maintain vascular tone within optimal limits in order to prevent damage to their walls with hemorrhage into the patient's brain.

For patients with hypertension who are over the age of 85, taking this kind of drugs is a constant rule, the implementation of which ensures not so much the treatment of hypertension, but rather the prevention of its aggravation and the transition to a more complicated stage. At a younger age, after completing the therapeutic course with the indicated medications, a stable remission may occur, which will allow the elderly person to return to their usual way of life and temporarily forget about such unpleasant symptoms of hypertension as headache, chills, dizziness, nausea, darkening of the eyes, noises in the head and vomiting.

Representatives of alternative medicine offer a wide selection of different recipes for alternative treatment with the preparation of drugs for hypertension, even at home. This method of treating arterial hypertension includes the use of decoctions from medicinal herbs such as golden mustache, hawthorn, motherwort, lemon balm, marsh creeper, strawberry. Decoctions are very simple to prepare. It is enough to add 10-15 grams of a dried plant to a metal container, pour 1 liter of water over it and slowly boil for 20 minutes. After cooling down, the home remedy for hypertension is ready to use. Depending on the type of medicinal herbs, the dosage and recipe may differ slightly. The use of herbal decoctions is also beneficial for diabetes mellitus.

Another equally effective way of treating hypertension in the elderly is alcoholic tinctures made on the basis of chokeberry, viburnum, hawthorn, spruce cones, motherwort. The principle of preparation of such funds is that the raw material in the form of berries or herbs is poured into a glass jar, poured with ethyl alcohol, suitable for consumption, or vodka is used. After this, the process of infusion of the medicine takes place, which lasts from 2 to 3 weeks. Elderly people are shown to take alcohol tinctures for hypertension a few teaspoons a day and periodically measure blood pressure. This method of treatment is often used in therapeutic methods according to Neumyvakin.

Provides a complex of breathing techniques that make up a special order and time interval of inhalation and exhalation of air. At the same time, the abdominal and pectoral muscle fibers are involved in the physiological process, which makes it possible to saturate the body of an elderly person with a sufficient volume of oxygen, improve blood circulation, strengthen the walls of the great vessels and thereby reduce the likelihood of an increase in blood pressure. In combination with breathing exercises, cardiac loads have proven themselves well, when the patient performs exercises for the respiratory and cardiovascular systems, and then immediately squats, does push-ups, or takes other physical actions without prior rest. This method of treating hypertension is used as the main one in the early stages of the development of the disease, and is also used as an adjuvant in the prevention of hypertensive crises.

Which method of treating hypertension in older people to choose for a particular patient, to use all the methods of therapy at once or to focus on only one direction in medicine, is determined exclusively by the attending physician, who has an elderly person, taking into account the individual characteristics of his body and the severity of the developing disease , the degree of deterioration of blood vessels.

Modern drugs

For the treatment of hypertension in elderly people, the most popular are drugs from the group of diuretics, which ensure the rapid disposal of the body and all its tissues from excess fluid, due to the presence of which blood vessels are compressed and, accordingly, blood pressure rises. In old age, the kidneys no longer work so efficiently, therefore, the presence of excess fluid in the body of an elderly person is quite common. In general, the following categories of medicines are used at all stages of treatment:

This is a special group of drugs for the treatment of hypertension in the elderly, which are widely used in the treatment of a wide variety of pathologies that have arisen in patients due to age-related changes in the tissues of most vital organs and endocrine glands. In the case of the treatment of hypertension, alpha-blockers prevent excessive accumulation of blood in the region of the brain, which often happens during the peak of the hypertensive crisis. Regular intake of alpha-blockers helps to avoid ischemic stroke.

  1. Beta blockers.

These modern drugs for the treatment of hypertension in the elderly are indicated for patients suffering from stages 3-4 of hypertension who have already had a stroke or myocardial infarction provoked by the presence of chronic arterial hypertension. Medicines of this group stabilize blood circulation, heart rate, prevent the development of angina pectoris, arrhythmias, bradycardia, tachycardia. The presence of recent diseases of the heart muscle against the background of hypertension occurs in 75% of hypertensive patients over 70 years of age.

  1. Calcium salt antagonists.

Preparations of this drug group are divided into those that have a short-term effect, as well as prolonged ones, providing a gradual release of active substances aimed at balancing the blood electrolyte. Due to the biochemical reaction occurring in the blood of a patient with hypertension, after taking the medication, blood pressure decreases to optimal levels. Medicines in this category practically do not cause side effects, and the number of contraindications is minimal, and basically all of them are associated with the presence of severe pathologies of the circulatory system in the patient.

In everyday life, these medicines are also called diuretics. Their use in old age is justified by the fact that all excess fluid is removed from the patient's body by stimulating the kidneys to work harder. Due to this, it is possible to avoid the formation of edema in the region of the great vessels, an excess of fluid in the blood and, accordingly, prevent an increase in blood pressure. Taking diuretics does not provide for the development of a complex therapy regimen, but drugs in this group have a number of serious side properties, including: washing out of potassium, calcium and magnesium salts, which negatively affects the functioning of the nervous system, heart and the structure of the bone tissue of the musculoskeletal system.

What kind of drug to prescribe to the patient, its dosage and duration of administration, is determined by the therapist. Self-treatment of hypertension in old age is categorically contraindicated and will end in severe consequences for the patient's health.

IT'S IMPORTANT TO KNOW!

Given the venerable age of patients, the treatment of hypertension in the elderly is specific in nature, in compliance with a specific therapy regimen, which consists of the following points:


Each attending physician has the right to independently adjust the course of therapy, to include other drugs and techniques in it, if their use improves the health of the elderly patient and accelerates his full recovery.

New in treatment

Methods of dealing with arterial hypertension in the elderly have not changed significantly over time, despite the fact that medicine in this area has stepped forward and every year scientists are inventing new medicines that make it possible to more effectively control high blood pressure. Therefore, among the innovations in this area, new types of diuretic drugs can be distinguished, which not only remove water from the patient's body, but also retain calcium, potassium and magnesium salts. This is very important for the preservation of the ionic balance, without which the stable work of the heart, kidneys, brain and metabolic processes in the body are impossible. If hypertension has passed to the malignant stage of its development and surgical intervention is required with the removal of altered tissues of vital organs, then laser surgery methods are used, which are the least traumatic for the elderly organism.

Hypertension is considered an age-related disease that develops in old age. Despite the fact that young people are susceptible to it, a large percentage of hypertensive patients are among the elderly population. The reasons for this lie in the natural aging of the body and concomitant diseases. But this does not mean that the pathology does not need to be treated. Provided that risk factors are taken into account and an integrated approach, the treatment of hypertension in the elderly gives lasting positive results.

Features of hypertension in old age

Hypertension is one of the most common diseases in adults. It is diagnosed in every second patient 60 years old and in almost all patients after 70–75 years. The norm of arterial parameters for them ranges from 140-145 to 85-89 mm Hg. Art. If it is exceeded, it is considered a pathological disorder in the work of the cardiovascular system that requires medical attention.

Senile hypertension is undoubtedly treatable, but it has its own characteristics. When choosing an effective therapy, important nuances of the elderly are taken into account:

  • vascular elasticity and tone are lost, blood flow worsens;
  • vessels become fragile and brittle, do not withstand pressure drops;
  • the risk of hemorrhage and thrombosis is significantly increased;
  • cholesterol deposits accumulate on the walls, atherosclerotic plaques form;
  • the heart muscle wears out, poorly regulates cardiovascular activity;
  • the work of the kidneys and adrenal glands is disrupted;
  • concomitant diseases develop.
Essential hypertension occurs in almost 80% of elderly people

For these reasons, the treatment of mature patients is difficult. Care is required in prescribing medications, taking into account possible adverse reactions. The approach should be comprehensive, aimed not only at stabilizing blood pressure, but also at maintaining good health and wellness in general.

Why does hypertension occur in the elderly?

There is no single reason for the development of hypertension. The leading role is played by a set of negative factors that have accumulated throughout life:

  • sedentary lifestyle;
  • work in hazardous production;
  • great physical activity;
  • constant stress, emotional overload;
  • alcohol abuse, smoking;
  • unhealthy diet, excess fat and salt in the body;
  • overweight, obesity;
  • chronic diseases of the endocrine system (diabetes mellitus, hypothyroidism);
  • pathology of the kidneys, adrenal glands, heart;
  • menopause;
  • hereditary predisposition.

The listed reasons, along with natural aging of the body, lead to dysfunction of cardiovascular activity.


Adaptive capabilities with aging of the body progressively decrease, therefore, the frequency of occurrence of hypertensive crises in elderly hypertensive patients is several times higher

How hypertension manifests itself in old age

The clinical picture of hypertension is standard regardless of age. The only difference is that in older people the symptoms are usually blurry and indistinct. The malaise is often attributed to old age or the usual overwork.

The disease is manifested by a set of characteristic signs:

  • dizziness, darkening in the eyes;
  • headaches of a throbbing or pressing nature;
  • noise in ears;
  • redness of the face as a result of a rush of blood;
  • rapid heartbeat and pulse;
  • swelling of the hands and feet;
  • chills, sweating;
  • anxiety, fear of death.

Feeling unwell can occur suddenly against the background of a slight load and pass on its own at rest. But it needs attention anyway. Untreated hypertension for a long time is fraught with heart failure, heart attack, stroke, the risk of which increases significantly after 60 years.


Frequent symptoms of high blood pressure in the elderly are: impaired coordination of movements

Diagnosis of the disease

When the first signs of malaise appear, you should seek the advice of a cardiologist. Even if there are no symptoms, every elderly patient should undergo preventive examinations. This allows you to identify the disease at an early stage, preventing the development of complications.

Examination for arterial hypertension includes:

  • examination by a specialist, collection of complaints and anamnesis;
  • systematic measurement of blood pressure indicators to determine the degree, stage, form of pathology (during this period, if possible, no antihypertensive drugs are taken);
  • a general blood test to assess the state of health in general;
  • analysis of sugar and cholesterol levels, an increase in which leads to vascular problems;
  • an electrocardiogram to diagnose cardiac activity;
  • Ultrasound of the heart as an additional and detailed method for examining the work of the organ;
  • dopplerography to determine the state of blood vessels and blood flow in them.

Hypertension often affects target organs, which suffer from prolonged high blood pressure. Therefore, an examination of the fundus, kidneys, stomach, and abdominal organs is additionally prescribed. All methods are safe and performed on an outpatient basis.


To correctly diagnose hypertension, it is necessary to take several measurements in one person.

Principles of hypertension treatment in the elderly

Treatment of hypertension in old age is done with caution. It is selected on an individual basis, depending on the stage of the disease and concomitant diseases. Older people are more prone to adverse reactions from medications, so medications should be gentle with the lowest effective dosage.

The disease is not completely cured due to irreversible changes in the body, but the state of health is successfully maintained for a long time. Therapy is usually given on an ongoing basis, meaning that the prescribed medication will have to be taken for the rest of your life.

An important point is an integrated approach that assumes:

  • taking medications that normalize blood pressure, improve the condition of blood vessels and the work of the heart;
  • the use of traditional medicine as an additional aid;
  • adherence to a healthy lifestyle and proper nutrition;
  • physiotherapy, sanatorium improvement.

A properly selected set of measures reduces the risk of complications (stroke, heart attack) by 30-40% and prolongs life.


Drug treatment is recommended

Drugs for treating hypertension in the elderly

Medicines for hypertension in old age are represented by several pharmacological groups:

  1. Diuretics They are used to remove excess salt and fluid from the body. The diuretic action allows you to relieve swelling and reduce blood pressure. Thiazide-like ("Chlorthalidone", "Indapamide") and potassium-sparing ("Veroshpiron", "Spironolactone") drugs are usually used for hypertension in the elderly.
  2. Beta-blockers. The hypotensive effect occurs as a result of a decrease in the heart rate. The load from the myocardium is removed, arterial parameters fall. They are actively used in the postinfectious period. Representatives: Propranolol, Bisoprolol, Enaprilin.
  3. Sartans. They block angiotensin 2 receptors, reducing vascular resistance, normalizing blood flow and blood pressure, preventing myocardial hypertrophy. On a long-term basis, "Losartan", "Telmisartan", "Olmesartan" are taken.
  4. ACE inhibitors. Drugs for hypertension for the elderly with a vasodilator effect. They have a cardio- and nephroprotective effect. They act quickly and are mainly used to relieve hypertensive crisis (Captopril, Lisinopril).
  5. Alpha blockers. Designed to eliminate the negative effects of adrenaline on pressure. Prescribed as long-term vasodilator therapy ("Tamsulosin", "Prazosin").
  6. Calcium antagonists. Modern medicines for hypertension for the elderly with bronchial asthma and atherosclerosis. They regulate the calcium content in the myocardium, dilating the coronary vessels. Used "Nifedipine", "Verapamil".

Medicines for hypertension are taken strictly according to the doctor's prescription with constant monitoring of vital signs.


Any antihypertensive drug is prescribed to be taken in a certain dose.

Hypertension in the Elderly: Traditional Medicines

It is quite effective to treat hypertension in the elderly with traditional medicine. The correct combination of home methods with traditional ones gives a good result.

To cope with the disease helps:

  • a mixture of honey and ground walnuts is consumed daily;
  • freshly squeezed grapefruit juice or fresh fruit lowers cholesterol and blood pressure;
  • carrot or beet juice with a spoonful of honey is taken three times a day (you can add grated horseradish and lemon);
  • a decoction of the herbal collection of motherwort, mint, thyme, chokeberry is drunk in 1 tbsp. l. before meals;
  • an infusion based on licorice, St. John's wort, yarrow, rose hips, mountain ash and hops is used before each meal;
  • a garlic-honey mixture of a head of garlic, a spoonful of honey and a few drops of lemon juice is taken after breakfast;
  • crushed with sugar viburnum berries are used fresh or added to tea;
  • warm baths with mint, St. John's wort and lemon balm are relaxing and soothing.

The feasibility of using alternative methods and compatibility with medications is discussed with the attending physician.


With hypertension in the elderly, recipes of traditional medicine will be good helpers in the treatment of the disease

Sanatorium treatment of hypertension in old age

After a hypertensive crisis or heart attack, it is recommended to undergo a spa recovery. A calm environment and constant supervision of qualified personnel will speed up recovery from stress. This method is no less effective as a prevention of hypertensive complications.

In the conditions of a sanatorium, it is useful to go through:

  • aromatherapy sessions;
  • special dietary food;
  • physiotherapy exercises;
  • laser therapy;
  • electrosleep;
  • balneotherapy using special baths;
  • oxygen cocktail;
  • herbal phyto procedures.

There are many specialized sanatoriums that deal with the problems of the cardiovascular system. To improve health and improve health, it is advisable to visit them annually.


The obligatory procedures of spa treatment are physiotherapy exercises.

Diet food

An important aspect of life for hypertensive patients is proper nutrition. Foods eaten can improve or worsen the condition.

Therefore, it is very important to monitor the daily diet and include in it:

  • fresh fruits and vegetables;
  • buckwheat, oatmeal, rice porridge;
  • lean beef, chicken, rabbit meat;
  • low-fat fish (hake, pollock, blue);
  • fiber, bran, whole grain bread;
  • dairy products;
  • not less than 1.5-2 liters of plain water.

Dishes are boiled, steamed or in the oven, salads are seasoned with olive oil. All food should be fresh and in moderation.

Hypertensive patients should refrain from:

  • fatty and fried foods;
  • canned food and homemade pickles;
  • semi-finished products and fast food;
  • sausages, smoked meats;
  • a lot of salt;
  • alcoholic beverages.

Keeping track of your diet is not difficult if you set yourself such a task. Healthy meals can be delicious, too, and most importantly, healthy.

Prevention of hypertension in old age

Even the best drugs for hypertension for the elderly may not cope with pathology if you do not follow the basic rules of a healthy lifestyle:

  • take daily walks in the fresh air;
  • do morning exercises (with the permission of the doctor);
  • stop smoking and drinking alcohol;
  • monitor weight, cholesterol and blood sugar;
  • observe the daily regimen with 8 hours of sleep and rest time;
  • do not engage in heavy labor activities;
  • avoid conflict situations and stress;
  • follow the doctor's prescriptions and regularly undergo preventive examinations by a cardiologist.

The implementation of simple recommendations will help not only to avoid severe hypertension, but also to improve health, achieve stable arterial parameters, significantly reduce the risk of heart collapses and prolong life into old age.