Therapeutic management of elderly hypertensives with concomitant ischaemic heart disease.

Abstract

CHARACTERISTICS OF ELDERLY HYPERTENSIVES: Hypertension is most prevalent in older patients and is associated with increasing morbidity and mortality with age. Elderly hypertensives often suffer from concomitant diseases, such as ischaemic heart disease, caused by age-induced modifications to the cardiovascular system, haemodynamic function and neurohormone activity. THERAPEUTIC MANAGEMENT: Therapeutic management of elderly hypertensives with concomitant ischaemic heart disease must take account of the pharmacodynamic and pharmacokinetic changes that occur in older subjects and drugs should be selected for their efficacy in both diseases. Since elderly subjects often metabolize drugs more slowly, this population is particularly susceptible to drug-drug interactions and pharmacologically induced side effects. CHOICE OF DRUGS: The present review outlines the usefulness of diuretics, beta-blockers, angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers in elderly hypertensives with ischaemic heart disease.