Hypertension is the most common pathology among the adult population of the planet. High blood pressure (BP) often causes death or serious consequences. For example, heart attack, stroke or disability.
Drug therapy for cardiovascular disease in elderly patients is very complex.
Age-related changes in the body often react unfavorably to taking medications for blood pressure. Such patients require an individual approach and additional clinical studies before starting treatment.
When is medication required?
Any treatment begins with conservative therapy. Older patients are advised to give up bad habits and establish a proper diet. If conservative methods do not give a positive prognosis, then drug treatment is used.
This therapy is justified in the following cases:
- If blood pressure does not fall below 150 mm Hg.
- The patient is bothered by a headache, compression in the chest and back of the head, and bleeding from the nose.
- The person feels powerless, anxious, and irritable.
- There is a high risk of complications from the heart and kidneys.
Drug therapy
Drug therapy for hypertension in older adults aims to reduce the risk of heart, kidney, and brain complications. It controls a person’s comfortable level of blood pressure and effectively affects his life expectancy.
Any group of antihypertensive drugs can be used to treat people over 60 years of age.
The tablets should be prescribed by a cardiologist or therapist after consultation. Most often, angiotensin-converting enzyme inhibitors, AT1 receptor blockers, calcium antagonists and thiazide diuretics are recommended for this age category. The latter are effective if isolated systolic hypertension is present.
Beta-blockers, although they are a first aid drug for hypertensive patients, are marked as drugs with little antihypertensive activity for elderly patients. Diuretics in moderate doses have been shown in a number of clinical trials to be a powerful and stable means of maintaining blood pressure at camphor levels in older patients.
Combination therapy is indicated for severe hypertension and the risk of severe complications. The choice of drug and dose depends on the individual characteristics of the body.
The best medications for hypertension
A person’s desire to be treated with the best blood pressure pills is understandable and justified, but one must understand that ideal medicines do not exist. The best drug will be one that has shown effectiveness in treatment and does not cause side effects. This is the importance of individual selection of antihypertensive drugs.
The category of the best blood pressure pills, without a doubt, includes medications that have been taken for years by patients in developed countries and demonstrate medicinal properties without significant side effects. Today the most popular:
- drugs from the group of angiotensin II receptor blockers (ARBs), or sartans;
- Third generation calcium blockers (lercanidipine) are increasingly being prescribed;
- ACE inhibitors and diuretics receive good reviews.
The best drugs for older people are called Indapamide, Captopril, Spironolactone.
As for safety, this is also an indispensable condition for determining the drug of choice. The safest group rightfully includes modern potassium-sparing diuretics, ACE inhibitors and sartans. But the safety of even the best high blood pressure pills does not mean that they guarantee a complete absence of side effects. In persons with individual intolerance to medicinal components or hidden pathologies, negative reactions may occur. Therefore, even the safest pills for lowering blood pressure should be taken only after a preliminary examination and consultation with a doctor.
Effective blood pressure medications
Self-medication of cardiovascular diseases is life-threatening! Only a certified specialist can choose the right, and most importantly, effective drug for a hypertensive patient.
When prescribing blood pressure medications for elderly and elderly people, the doctor must take into account age-related changes in the body.
The doctor examines medical records and prescribes the necessary tests. Be sure to check the heart, stomach, kidneys and eyes for drug tolerance.
Table: popular drugs for the treatment of hypertension in old age
| Group of drugs | Name of drugs |
| Diuretics - diuretics | indapamide, hypothiazide, amiloride, spironolactone. |
| Calcium antagonists | amlodipine, isradipine, nifedipine retard, diltiazem, felodipine, verapamil. |
| β-blockers | anaprilin, metoprolol, acebutolol, atenolol. |
| Angiotensin receptor blockers | losartan, valsartan, telmisartan. |
| ACEI | captopril, lisinopril, enalapril, fosinopril |
| ά1-adrenergic receptor blockers | oxazosin, terazosin, prazosin. |
| Drugs with central neurotropic action | guanfacine, clonidine, methyldopa, moxonidine |
| Reducing cholesterol | atorvastatin, simvastatin, lovastatin. |
| Reduced thrombotic complications | aspirin, thrombotic ACC. |
| For heart | preductal, mildronate, phosphocreatine. |
Diuretics and calcium antagonists are most often used in the initial treatment of hypertension. Diuretics can be combined with other first aid medications.
The duration of treatment and treatment tactics depend on monitoring the patient. Most often, medication use for this category of citizens is lifelong.
Calcium antagonists
The next group of medications in the treatment of hypertension in the elderly. By suppressing the excess release of calcium into the vascular wall and cardiac tissue, the arterioles expand, which brings blood pressure to normal levels.
For high blood pressure, Amlong, Corvadil, Tenox, etc. are recommended. Amlodipine and Verapamil-Retard are especially popular.
In older people, they do not cause addiction or side effects, subject to compliance with the doctor's instructions.
Amlodipine
A long-acting hypotonic agent is part of the primary treatment in most cases. In some cases, doctors recommend that in old age choose medications that contain Amlodipine.
The medicinal substance N ranges from 20 to 100, the dosage is 5 and 10 mg. For elderly patients, Amlodipine is prescribed at a maintenance concentration of 5 mg, however, if blood pressure rises to a critical level, a single double dose (10 mg) is possible.
The basis for use is hypertension in the chronic stage, as well as as a result of a stroke.
There are two contraindications to taking Amlodipine in old age:
- Myocardial infarction.
- Diseases of the urinary system during exacerbation.
The drug is taken once a day, preferably in the first half of the day. The initial dosage is ½ tablet, with subsequent increase.
Elderly patients with low body weight and kidney disease are advised not to exceed 5 mg per day, otherwise the risk of developing undesirable consequences increases:
- jaundice;
- vomit;
- nocturia;
- hyperglycemia;
- extrasystole.
The price for Amlodipine does not exceed 200 rubles. The average is 80-170 rubles.
There are many drug substitutes, and all of them contain amlodipine: Amlodac, Amlong, Azomex.
Verapamil-Retard
The calcium channel blocker Verapamil is a modern treatment for hypertension for older men and women. Sold in tablet form of 40 and 80 mg. The active ingredient is verapamil hydrochloride. The drug is covered with a protective film.
Under the influence of the drug, resistance in the pulmonary and systemic circulation is normalized. Complete absorption of the drug occurs in the gastrointestinal tract, followed by binding to blood proteins.
For elderly people, the indication for taking Verapamil-Retard is an increase in blood pressure against the background of hypertension and post-stroke condition, as well as in case of heart and valve failure. Treatment is not recommended for:
- hypotension of blood pressure;
- dystrophy of the left ventricle of the heart muscle;
- in the presence of chronic renal failure and liver failure - with increased caution.
Verapamil is suitable for the treatment of age-related hypertension in diabetes mellitus types 1 and 2 and bronchial asthma.
According to the instructions for use, the medicine is taken three times a day in the amount of 80 mg (1 or 2 tablets). To maintain normal levels, elderly patients are recommended to take 180 mg per day, dividing the dose into 2 doses. The medication should be taken with a small amount of water a few minutes before meals.
In the case of hypertension in the elderly, the course of treatment is not defined. The ampoule solution is used in the treatment of hypertensive crisis - it is administered intravenously.
Despite the effectiveness of the drug, Verapamil is characterized by a number of side effects:
- weight gain;
- constipation;
- headache.
Elderly hypertensive patients may develop syndromes of lethargy and nervousness. Thrombocytopenia may be detected in the blood, so there is a need for monthly monitoring of a general blood test.
The main analogue of Verapamil-Retard is Verapamil. The medicines have an identical composition and the same active ingredient. The price for Verapamil is 45-100 rubles, for Verapamil-Retard – from 150 to 280 rubles.
Medicines for hypertensive crisis
A hypertensive crisis is manifested by high and persistent blood pressure, which causes discomfort for a person. It can occur suddenly or be the result of lack of adequate treatment.
In such cases, an ambulance is always called. The doctor uses a strong tablet drug (capoten, captopril) or a drug for intramuscular and intravenous administration. If blood pressure does not decrease, the patient is taken to the intensive care unit.
Further treatment tactics depend on the severity of the disease. The hospital may prescribe intravenous injections of clonidine or intramuscular injections of magnesium sulfate.
Features of the treatment of hypertension in the elderly
Antihypertensive drugs must be taken when the systolic value exceeds 160 mm Hg. Art. Fluctuations in the upper values from 140 to 160 are called the “gray zone”.
Older people need to take medications to lower blood pressure for life. Doctors try to select antihypertensive drugs with few or no side effects.
If the patient has a history of diabetes mellitus, a heart attack, stroke, or other severe conditions, the selection of antihypertensive drugs is carried out with extreme caution.
For convenience, modern long-acting antihypertensive drugs are selected, which can be taken once a day.
At the beginning of therapy, the patient is prescribed half the standard dose, gradually increasing it. This measure is necessary for the body to adapt to changes.
The medicinal product must have convenient packaging. Otherwise, patients suffering from visual impairment and arthritis may find it difficult to open the package, so they may not take the pill on time.
Ignoring arterial hypertension is dangerous for patients of any age, but especially the elderly. Chronic increase in pressure causes additional stress on the heart, vascular and renal systems, as a result of which a hypertensive crisis may occur, accompanied by serious consequences: heart attack, stroke, impaired renal function, pulmonary edema. This increases the risk of patient disability and even death.
In addition to drug therapy, the patient must reconsider his usual lifestyle. It is necessary to eliminate factors that provoke increased blood pressure: physical inactivity, alcohol, smoking, junk food, etc.
Side effects from taking pills
Side effects from taking medications that lower blood pressure can occur most often with long-term use and in combination with another drug.
| Drug class | Possible reactions |
| β-blockers | deterioration of blood lipid composition and hypoglycemia. Rarely when using metoprolol or be-taxolol. |
| calcium antagonists | feeling of heat, headache, hypotension, swelling of the legs. |
| ACEI | dry cough, hypotension. |
| angiotensin receptor blockers | cough |
| Drugs with central neurotropic action | Drowsiness, loss of energy, dry mouth, swelling, nausea, diarrhea. |
The patient must take medications strictly according to the doctor's regimen. Even after setting a target blood pressure level for your age group, it is not recommended to stop treatment. Replacement of the drug and its complete cancellation can only be prescribed by the attending physician.
Therapeutic features
High blood pressure in older people must be treated, for which medications that effectively reduce blood pressure are selected.
Such therapy is based on the following principles:
- Systolic pressure should not be reduced too much (no more than 30% of the available data). Otherwise, you will have to take blood pressure-raising drugs to prevent kidney or brain failure.
- The reduction in pressure should occur systematically over several weeks. Too sudden changes will only harm the body.
- Choosing and taking medications is a serious undertaking. It is necessary to take into account other diseases that are currently progressing or have a history.
- If coronary artery disease occurs, it is not recommended to reduce blood pressure too much; it is not necessary to reach the established norm.
- Regular monitoring of blood pressure measurements is recommended.
Important! When different people use the same medication to treat hypertension, the therapeutic result will be radically different. It all depends on the individual characteristics of each person, age-related changes within the body, and the neglect of the pathological process.
Prevention
Elderly people require peace, relaxation and tranquility. Any nervous experience negatively affects blood pressure. It is not for nothing that doctors constantly recommend medical sanatoriums to such patients. Where, in addition to medical procedures, people meet and find friends.
Advice for older patients from doctors:
- Reduce table salt consumption;
- Measure blood pressure in the morning and evening;
- Consume more vitamins and minerals;
- Stop smoking and drinking alcohol;
- Start the fight against obesity;
- Engage in physical therapy under the supervision of a specialist;
- Use the services of a psychologist;
- Consult with your doctor once every three months;
- Use herbal medicine methods.
There is no magic pill.
The choice of dose and brand of the drug directly depends on concomitant diseases. Only a doctor can prescribe medications that will be effective on an individual basis. Author of the article Svetlana Anatolyevna Ivanova, general practitioner
Is treatment necessary?
For a long time, medical experts agreed that older people should not be treated for hypertension. The explanation for this statement was that antihypertensive medications lead to unsafe side effects for health, against the background of which new diseases develop with unforeseen complications. Basically, only observations were made of the well-being of elderly people suffering from high blood pressure; no therapeutic measures were taken.
Today, elderly hypertensive patients actively take effective antihypertensive drugs, which significantly improve their own well-being. More than 50% of people who undergo correctly selected and adequate treatment are prevented from strokes and the development of cardiac complications.
Normalizing blood pressure is a complex process, which is preceded by a comprehensive examination of a person. Knowing from the results obtained about the state of the patient’s vascular system, the doctor will select the right medications. It is important to take into account concomitant diseases, which may be included in the list of contraindications for the selected medication and will only harm a person’s health.
