SELECTION OF ANTIHYPERTENSIVE MEDICATIONS FOR THE ELDERLY

Lowering the blood pressure of hypertensive elderly patients can reduc e the risks of stroke, heart disease, and renal failure. Although chan ges associated with the aging process may influence the selection of a ntihypertensive agents, coexisting disease plays an even greater role. For example, hypertensive patients with coronary artery disease may r eceive an added benefit through treatment with beta blockers or calciu m channel blockers. Similarly, the symptoms and manifestations of hear t failure are best treated with angiotensin-converting enzyme inhibito rs, which tend to improve cardiac output by reducing afterload. Conver sely, some antihypertensive agents are best avoided in the face of cer tain diseases, such as thiazide diuretics or beta blockers in patients with diabetes mellitus.