Managing Hypertension in the Elderly: What is Different, What is the Same?

PURPOSE OF REVIEW: The goal is to discuss management of hypertension in the elderly.

RECENT FINDINGS: At 3.14-year follow-up of 2636 persons ≥75 years in the Systolic Blood Pressure Intervention Trial (SPRINT), compared with a systolic blood pressure (SBP) goal of <140 mmHg, a SBP goal of <120 mmHg reduced the primary endpoint of myocardial infarction, other acute coronary syndrome, stroke, heart failure, or cardiovascular death by 34% (p = 0.001), all-cause mortality by 33% (p = 0.009), heart failure by 38% (p = 0.003), and the primary outcome or death by 32% (p < 0.001). Absolute cardiovascular event rates were lower for the intensive treatment group within each frailty stratum. The incidence of serious adverse events was similar in both treatment groups. The SPRINT trial provides very important information on the efficacy and safety of lowering the SBP to <120 mmHg in elderly adults with hypertension.