American College of Cardiology Foundation/American Heart Association 2011 Consensus Document on Hypertension in the Elderly: A Few Comments for the Patient

Hypertension remains a major burden to cardiovascular health and is particularly troublesome in the elderly population. It can be a direct cause of kidney failure and strokes, and is a major risk factor for heart attacks and sudden death. Aronow, Fleg, Pepine et al1 published several points of interest in a recent consensus document which emphasize the major points in the management of hypertension. These points of interest discuss the epidemiology, treatment, lifestyle modification in hypertension as well as appropriate drug therapies for the hypertensive patient. I strongly recommend that patients with hypertension or at risk for hypertension review these comments, which are located at www.cardiosource.org and is cited below. In addition to their timely remarks, VI Heart emphasizes the following tenets in the treatment of our patients with hypertension.

1. Hypertension is known as the “silent killer”. Unfortunately, many younger patients are hypertensive but asymptomatic. These asymptomatic patients share the same risks of kidney failure, heart attacks, and chronic diseases of heart.
2. Elderly hypertensives are at particularly high risk for the complications of hypertension. Therefore, patients and their physicians should be particularly aggressive in reaching target goals for blood pressure levels, blood sugar levels, blood cholesterol levels.
3. It is important to realize that blood pressure readings normally vary throughout the course of the day. Accurate home blood pressure measurements are extremely useful in determining the true response to medications and other interventions. The phenomenon of “white coat hypertension” may make readings obtained in a medical setting less reflective of actual day-to-day blood pressure readings.
4. Prudent dietary choices which include portion control should become a routine part of everyone’s lifestyle but particularly those with cardiovascular disease and/or risk factors.
5. The choice of initial medications should be based on concurrent medical conditions and knowledge of the unique properties and interactions of an individual drug. However, drug therapy should not be considered a substitute for consistent aerobic exercise and dietary discretion.
6. Many patients with hypertension may also have diabetes, high cholesterol, and/or coronary artery disease. It is very common for multiple medications to be prescribed, each being utilized for a particular purpose. It is the responsibility of both health care providers and patients to collaborate to find regimens that are both effective and reasonably practical for the majority of patients. We strongly discourage cessation of prescribed cardiovascular medications without discussion with your medical provider. It is vital that each patient understand the risk/benefit profile of his medical regimen and act accordingly.

The team at VI Heart continues to work toward improving your cardiovascular health. We hope these points help to keep you “Heart Healthy!”

Roy D. Flood, Jr. MD
Virgin Islands Heart, LLC

References

1. Aronow WS, Fleg JL, Pepine CJ, et al. J Am Coll Cardiol 2011:April 25