Ca channel blockers, ARBs, angiotensin-converting enzyme (ACE) inhibitors and low-dose diuretics are recommended as first-line antihypertensive drugs in elderly and nonelderly patients.Apr 7, 2014
The largest number of elderly patients with systolic hypertension require dual antihypertensive therapy or even triple antihypertensive therapy to control systolic BP. The preferential combinations are: ACEI and diuretic; ARB and diuretic; or ACEI and dihydropyridine calcium antagonist.
Angiotensin Receptor Blockers ARBs are considered the alternative first-line treatment for hypertension in the elderly population when a diuretic is contraindicated. In elderly hypertensive patients with diabetes or HF, ARBs are considered first-line treatment and an alternative to ACE inhibitors .
The new approach recommended by the British Hypertension Society is that first-line therapy in patients over 55 should be a calcium channel blocker or a thiazide -type diuretic . For patients who are younger than 55, ACE inhibitors are the first-line drug of choice.
ACE Inhibitors, or angiotensin receptor blockers (ARBs), are recommended as first line therapy because they lower blood pressure and the risk of stroke and heart disease. ACE inhibitors are cheap, well tolerated medications that end in -il (for example: lisinopril, enalapril, benazepril).
However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.
6 Outdated High Blood Pressure Medications You Should Consider Upgrading Atenolol. Furosemide (Lasix) Nifedipine (Adalat, Procardia) Terazosin (Hytrin) and Prazosin (Minipress) Hydralazine (Apresoline) Clonidine (Catapres)
Methyldopa , which works to lower blood pressure through the central nervous system, has the lowest risk of harming the mother and developing fetus. Other possible safe options include labetalol , beta blockers , and diuretics .
Generally, ACE inhibitors should remain the initial treatment of choice for hypertension. Angiotensin II receptor antagonists or angiotensin receptor blockers (ARBs) are used for patients who are unable to tolerate ACE inhibitors .
7 Drinks for Lowering Blood Pressure Tomato juice . Growing evidence suggests that drinking one glass of tomato juice per day may promote heart health. Beet juice . Prune juice . Pomegranate juice . Berry juice . Skim milk . Tea .
Elderly Blood Pressure Range for Men and Women
|Blood Pressure Category for Adults 65+||Systolic mm Hg||Diastolic mm Hg|
|Normal blood pressure||Lower than 120||Lower than 80|
|Elevated blood pressure||120 – 129||Lower than 80|
|High blood pressure stage 1||130 – 139||80 – 89|
|High blood pressure stage 2||140 or higher||90 or higher|
If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys resulting in a stroke, heart failure, or kidney failure.
As a general guide: high blood pressure is considered to be 140/90mmHg or higher (or 150 /90mmHg or higher if you’re over the age of 80) ideal blood pressure is usually considered to be between 90 /60mmHg and 120/80mmHg.
It is concluded that, while both amlodipine and losartan demonstrated a significant benefit for the treatment of mild to moderate hypertension, there were greater reductions in most BP measurements following treatment with amlodipine in comparison to losartan with or without HCTZ.
Recommended first-choice blood pressure drugs (and their acronyms) Thiazide diuretics . Calcium channel blockers – CCBs. Angiotensin -converting enzyme inhibitors -ACEIs. Angiotensin receptor blockers – ARBs .
The Eighth Joint National Committee (JNC 8) issued new blood pressure guidelines for seniors in 2014 recommending that individuals over age 60 aim for a reading below 150/90 mmHg. The JNC 8 recommendation for patients of any age with diabetes or chronic kidney disease is to aim for BP readings below 140/90 mmHg.
Amlodipine and lisinopril should not cause kidney damage and in fact are used to treat high blood pressure and slow the progression of chronic kidney disease (CKD).