Fast Five Quiz: Hypertension Management

Yasmine S. Ali, MD


January 24, 2019

Calcium channel blockers are quite useful because of their strong antihypertensive effects. Often, combining two drugs at a lower dose may be preferable to using a single drug at a high dose, because of the potential for adverse effects with the higher dose.

Low doses of diuretics may also be effective. Thiazide-type diuretics may be particularly beneficial for patients aged 55 years or older with hypertension or cardiovascular disease risk factors and for patients aged 60 years or older with isolated systolic hypertension.

The Systolic Hypertension in the Elderly Program (SHEP) trial found that chlorthalidone stepped-care therapy for 4.5 years was associated with a longer life expectancy at 22-year follow-up in patients with isolated systolic hypertension.

Beta-blockers may not be as effective as other first-line agents in patients aged 60 years or older, especially for stroke prevention, and should probably be used when other indications are present, such as heart failure, previous myocardial infarction, and angina.

Read more on the management of hypertension in the elderly.


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