Document Detail

Hypertension in the nursing home.
MedLine Citation:
PMID:  18755421     Owner:  NLM     Status:  MEDLINE    
Hypertension in a nursing home patient is a systolic blood pressure of 140 mm Hg or higher and 130 mm Hg or higher in a patient with diabetes mellitus or chronic renal insufficiency, or a diastolic blood pressure of 90 mm Hg or higher and 80 mm Hg or higher in a patient with diabetes mellitus or chronic renal insufficiency. Numerous prospective, double-blind, randomized, placebo-controlled studies have demonstrated that antihypertensive drug therapy reduces the development of new coronary events, stroke, and congestive heart failure in older persons. The goal of treatment of hypertension in elderly persons is to lower the blood pressure to less than 140/90 mm Hg and to less than 130/80 mm Hg in older persons with diabetes mellitus or chronic renal insufficiency. Elderly persons with diastolic hypertension should have their diastolic blood pressure reduced to 80 to 85 mm Hg. Diuretics should be used as initial drugs in the treatment of older persons with hypertension and no associated medical conditions. The selection of antihypertensive drug therapy in persons with associated medical conditions depends on their associated medical conditions. If the blood pressure is more than 20/10 mm Hg above the goal blood pressure, drug therapy should be initiated with 2 antihypertensive drugs, one of which should be a thiazide-type diuretic. Other coronary risk factors must be treated in patients with hypertension.
Wilbert S Aronow
Publication Detail:
Type:  Journal Article; Review     Date:  2008-07-30
Journal Detail:
Title:  Journal of the American Medical Directors Association     Volume:  9     ISSN:  1538-9375     ISO Abbreviation:  J Am Med Dir Assoc     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-29     Completed Date:  2008-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100893243     Medline TA:  J Am Med Dir Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  486-90     Citation Subset:  IM    
Department of Medicine, Division of Cardiology, New York Medical College, Valhalla, NY 10595, USA.
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MeSH Terms
Antihypertensive Agents / therapeutic use
Hypertension / drug therapy*,  epidemiology,  physiopathology
Nursing Homes*
United States / epidemiology
Reg. No./Substance:
0/Antihypertensive Agents

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