JLE

Médecine

MENU

Hypertension after 80 years. Sometimes we should deal with it, but who and how? Volume 9, issue 6, Juin 2013

Authors
Société Française de Documentation et de Recherche en Médecine Générale - gallois.pierre@wanadoo.fr

It is never too late to treat hypertension in the healthy elderly, but the overall context is essential. “Age” is not a matter of civil status. The facility in walking is a marker of overall health status for the elderly. The decision must take into account comorbidities, the quality of the autonomy, the difficulties of compliance, the risk of side effects (hypokalemia, orthostatic hypotension...) for which severity increases with age. Orthostatic hypotension is a strong predictor of cardiovascular risk. Sometimes associated comorbidities exacerbate this risk by themselves or as a result of their treatment. The “rule” is to remain cautious and gradual in achieving targets that nothing will allow to fix below 140/90, not to mention the essential interest of the “non-medicated”: a Mediterranean diet with slightly salty food, and moderate physical activity. The preferential indications of any drug follow the general rules and are guided by the presence of comorbidities and therefore the difficulty of poly-prescriptions and possible adverse effects.