Hypertension: how comorbid disease influences the choice of therapy. Part 4 of a roundtable discussion.
Two categories of comorbid conditions affect the choice of therapy for hypertension: compelling indications, where outcomes data show improved survival, and indications where therapies may be beneficial but do not affect survival. In patients with diabetes, low-dose diuretics effectively lower blood pressure, but metabolic derangements may occur. A diuretic may exacerbate urinary incontinence and therefore may not be a first-choice therapy for some older women. Monotherapy is not effective in controlling blood pressures in patients with renal insufficiency. In patients with a history of MI, even those age 85 and older benefit from beta blockade. Lowering blood pressure over a 3- to 5-year period is effective in preventing left ventricular hypertrophy and congestive heart failure.
Butler
R N
RN
Department of Geriatrics and Adult Development, Mount Sinai Medical Center, New York, USA.
August
P
P
Ferdinand
K C
KC
Phillips
R A
RA
Roccella
E J
EJ
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D051437:Renal Insufficiency / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology
D000959:Antihypertensive Agents