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AH in the elderly.

The results of randomized trials suggest that antihypertensive therapy reduces the risk of CVD and mortality in elderly patients with systolic-diastolic hypertension and ISAG.

The principles of treatment for elderly patients with hypertension are the same as in the general population. Treatment should begin with lifestyle changes. Limiting consumption of salt and weight loss in this category of patients have a significant antihypertensive effect. For the treatment of ISAG in old age, thiazide diuretics and dihydropyridine AK are most effective, which is proved by the results of large-scale studies completed. For drug therapy in elderly patients with systolic-diastolic hypertension, the first choice drugs are ARBs, thiazide diuretics and dihydropyridine AK.

The initial dose of antihypertensive drugs in some elderly patients may be reduced, however, in most patients of this category, the appointment of standard doses is required to achieve the target blood pressure. In elderly patients, special care is required when prescribing and titrating a dose of antihypertensive drugs because of the greater risk of side effects.
In this case, special attention should be paid to the possibility of developing orthostatic hypotension and measuring blood pressure also in a standing position.

The target level of blood pressure in systolic-diastolic hypertension should be 130-139 / 80-89

mmHg, and to achieve it often requires a combination of two or more antihypertensive drugs. With ISAG, the target level of GARDEN should be less than

150 mmHg The optimal level of DBP in elderly patients is not precisely determined, but according to the results of an analysis of a number of studies, a decrease in DBP is <70 mm Hg. and especially <

60 mmHg is accompanied by a worsening prognosis. Most elderly patients have other RF, POM and ACS, which must be considered when choosing a first-line antihypertensive drug. In patients over 80 years of age, AHT significantly reduces the risk of developing MTR and overall mortality. Therefore, the need for effective hypertension in patients of any age is beyond doubt.
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AH in the elderly.

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