Medical expert of the article
New publications
Hypertension in the elderly
Last reviewed: 07.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Hypertension in the elderly is most often observed in the age category over 60 years; it develops in the early or later periods of life. Symptomatic arterial hypertension caused by atherosclerosis (sclerotic, mainly systolic arterial hypertension), kidney disease or other causes may also occur.
The normal level of arterial pressure varies depending on age within a small range - at 60-69 years it is on average (130/80-135/80 mm Hg), at 70-79 years - (135-140/80-85 mm Hg), and at 80-89 years - (135-140/85-90 mm Hg). An increase in arterial pressure of more than (155/95 mm Hg) for people over 60 years old should be considered arterial hypertension, and not a manifestation of purely age-related changes in the cardiovascular system and neurohumoral mechanisms regulating its functions.
[ How does hypertension manifest itself in older people?
Arterial hypertension in the elderly, developing in the later age periods (mainly in the 7th decade), is characterized by comparatively poor subjective symptoms. Patients often complain of general weakness, noise in the head and ears, unsteadiness of gait and very rarely of headache. Hypertensive crises are rarer and less pronounced than in middle-aged people. Such clinical manifestation of the disease is explained by a decrease in the general reactivity of the body, in particular, the reactivity of the nervous system.
At the same time, such patients may experience severe functional shifts in a number of organs and systems, especially in the cardiovascular, kidneys, and central nervous system. Deep changes in the vascular wall as a result of atherosclerosis cause relatively easy development of cerebral and coronary circulation insufficiency, and renal blood supply.
What's bothering you?
Who to contact?
How is hypertension treated in the elderly?
Antihypertensive drugs are prescribed mainly for diastolic hypertension.
An indication for hypotensive therapy is arterial pressure exceeding (170/95 mm Hg), especially if there are complaints of dizziness, temporary deterioration of vision, etc. Treatment of such vascular hypertension is necessary to prevent the development of nephrosclerosis, cerebral and coronary circulatory failure, etc.
The most commonly used treatment for hypertension in people over 60 is monotherapy: beta-blockers or diuretics. Before prescribing beta-blockers, it is necessary to find out if there are any contraindications: heart failure, bradycardia, heart block or bronchospasm, beta-blockers are well tolerated and do not cause orthostatic hypotension. Several groups of beta-blockers are known:
- non-cardioselective without sympathomimetic activity (anaprilin, obzidan, thymolone);
- non-cardioselective with partial sympathomimetic activity (visken, trazicor);
- cardioselective (cordanum, betaloc, atsnolol).
If hypertension in elderly people is combined with angina, it is advisable to use anaprilin, visken. In case of heart rhythm disorders - cordanum, anaprilin. In patients with chronic respiratory diseases, it is advisable to use cardioselective beta-blockers (betaloc), which usually do not cause bronchospastic reactions.
In diabetes mellitus, non-selective beta-6 locators without partial sympathomimetic activity (obzidan) should not be used; these same drugs are contraindicated in cases of peripheral circulatory disorders (Raynaud's syndrome, obliterating enarteritis, atherosclerosis of the vessels of the lower extremities).
In recent years, hypertension in the elderly has been treated using calcium antagonists:
- dihydropyridine derivatives - nifedipine (corinfar, cordafen-phenitidine);
- benzothiazem derivatives - diltiazem (cardip)
- phenylalkylamine derivatives - verapamil (isoptin, finaptin);
- In geriatric practice, nifedipine is most often prescribed, especially in combination with beta-blockers (cordanum, visken), vasodilators (apressin).
For the treatment of elderly patients, a combination of corinfar with visken (pindopon) is effective, if necessary with the addition of loop diuretics (furosemide) or potassium-sparing diuretics (triamterene, veroshpiron).
A nurse caring for a patient with arterial hypertension must have a clear understanding of the effect of antihypertensive drugs on blood pressure. It is necessary to reduce the pressure and ease the work of the heart, improve the blood supply to the organs. However, an overdose of these drugs and a significant decrease in blood pressure, which can have a negative effect, must not be allowed.
It is not always necessary to inform the patient about the dynamics of arterial pressure and inform him about its high level. Even a small increase in arterial pressure in many patients causes anxiety, depression, which negatively affects the state of neuroregulatory mechanisms. When providing assistance to a geriatric patient during a hypertensive crisis, it is necessary to avoid the use of heating pads (to prevent burns due to reduced skin sensitivity), ice packs (to prevent hemodynamic disturbances in the vessels of the brain).
More information of the treatment