Frailty and hypertension in older adults: current understanding and future perspectives

Hypertens Res. 2020 Dec;43(12):1352-1360. doi: 10.1038/s41440-020-0510-5. Epub 2020 Jul 10.

Abstract

Hypertension is an important factor affecting the health of older adults. Antihypertensives can reduce stroke, cardiovascular events, and mortality in older hypertensive patients. Blood pressure management is difficult in older adults since geriatric syndromes such as frailty and comorbidities often coexist with hypertension. Recent guidelines propose taking functional status into account when targeting blood pressure in older people. Therefore, a better understanding and control of frailty risk factors could improve the prognosis of older adults with hypertension. However, there are relatively few studies on hypertension and frailty in older adults, especially studies focused on antihypertensive treatment. The goals, target values, and choice of antihypertensive treatment for frail older adults are still disputed. We reviewed the recent literature focusing on frailty and hypertension in older adults and propose a management process for screening and assessing frailty and hypertension before the use of antihypertensives. The process can support older adults with lifestyle interventions and frailty management and help them begin taking a single antihypertensive medication.

Keywords: Antihypertensive treatment; Blood pressure; Frailty; Hypertension; Older adults.

Publication types

  • Review

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Disease Management
  • Frailty / complications*
  • Frailty / diagnosis
  • Geriatric Assessment
  • Health Status Indicators
  • Humans
  • Hypertension / complications*
  • Hypertension / drug therapy
  • Prognosis

Substances

  • Antihypertensive Agents