title: Alternative first-line therapies in geriatric hypertension.
abstract: Between 45 and 60% of elderly persons have mild to moderate hypertension. In those with combined systolic/diastolic hypertension, blood pressure reduction significantly reduces morbidity and mortality. Secondary causes of hypertension, particularly renovascular, should be considered in elderly patients with a recent history of hypertension. Because of their proven efficacy and low cost, low-dose thiazide diuretics remain an important first-line therapy. Angiotensin-converting enzyme (ACE) inhibitors and calcium-channel blocking agents have also been shown to be effective and well-tolerated in the elderly. Increased attention is being paid to adverse drug effects and to the overall effect of antihypertensive therapy on quality of life. ACE inhibitors are particularly attractive in the elderly due to their possibilities in this area. In the elderly, the combination of a low-dose thiazide diuretic with an ACE inhibitor enhances antihypertensive efficacy while blunting the adverse metabolic effects of the diuretic.
authors.affiliation: Department of Family and Community Medicine, York Hospital, PA.
authors.forename: R W
authors.initials: RW
authors.lastname: Sloan
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use; D005853:Geriatrics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D010349:Patient Compliance
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers