Hypertension in the Elderly

Although elderly hypertensive patients are the subjects of the largest body of outcomes trial data, as a group they are not getting the maximum benefit from antihypertensive medications. In Hypertension in the Elderly, a panel of leading academic physicians comprehensively reviews all aspects of this problem using the most current clinical data. Topics range from basic concepts, epidemiology and trials, and evaluation and management, to pharmacological treatment, special populations, and adherence, all presented with an emphasis on the optimal management of patients. The authors examine in detail the mechanisms of hypertension in the elderly, particularly age-related changes in vascular stiffness, and methodically review the lifestyle and outcomes trials that were conducted in older persons. The problems of clinical evaluation, secondary hypertension, and target organ damage are also fully addressed, and a practical approach is provided for correctly determining blood pressure, one of the most important tasks in evaluating an older patient. Extensive discussions of pharmacological therapy detail the role of individual drug classes, including diuretics and b-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium antagonists, a-1 blockers, and combination drug therapies. Additional chapters focus on special populations, such as African Americans, patients with diabetes, and patients with arthritis, as well as on the clinician's role in improving therapeutic adherence in older patients.
Comprehensive and authoritative, Hypertension in the Elderly offers family practitioners and general internists an up-to-date, user-friendly reference on the diagnosis, treatment, and complications of hypertension in the elderly.

Zusammenfassung
A comprehensive review of all aspects of hypertension in the elderly using the most current clinical data. Topics range from basic concepts, epidemiology and trials, and evaluation and management, to pharmacologic treatment, special populations, and adherence, all presented with an emphasis on the optimal management of patients. The authors examine in detail the mechanisms of hypertension in the elderly, the lifestyle trials and outcomes trials that were conducted in older persons, as well as the problems of clinical evaluation, secondary hypertension, adherence, and target organ damage. Extensive discussions of pharmacologic therapy detail the role of all the major drug classes.

Inhalt
Basics.- The Importance of Hypertension in the Geriatric Population.- Age-Related Changes in the Cardiovascular System.- Aging, Arterial Stiffness, and Systolic Hypertension.- Pharmacological and Pharmacodynamic Alterations in the Elderly.- Epidemiology and Trials.- Epidemiology of Hypertension in the Older Patient.- Nonpharmacological Trials in the Older Hypertensive Patient.- Clinical Trials of Hypertension in the Older Patient.- Evaluation and Management.- Blood Pressure Measurement in Older Patients With Hypertension.- Clinical Evaluation of the Elderly Hypertensive.- Hypertension in the Elderly.- Diagnosis and Management of Hypertensive Renal and Renovascular Disease in the Elderly.- Heart Failure in the Older Hypertensive Patient.- Ischemic Heart Disease in the Older Hypertensive Patient.- Cerebrovascular Disease in the Elderly Hypertensive.- Pharmacological Management.- Diuretics and ?-Adrenergic Blockers in the Management of Hypertension in the Elderly.- Assessment of the Role of ACE Inhibitors in the Elderly.- Use of Angiotensin Receptor Blockers in the Elderly.- Clinical Trials With Calcium Antagonists in Older Patients With Hypertension.- ?-Adrenoceptor Blockers for Management of Hypertension in the Elderly.- Combination Drug Therapy in the Elderly.- Special Populations.- A Attitudes Regarding Hypertension Among Older African-American Adults.- Treatment of Hypertension in the Elderly Patient With Diabetes.- Management of Hypertension in Older Patients With Arthritis.- Adherence.- The Clinician's Role in Improving Therapeutic Adherence and Blood Pressure Control in Older Hypertensive Patients.