Antihypertensive drugs in the elderly - the evidence of benefit

Hypertension is a major cardiovascular risk factor. The commonest mode of d eath in the elderly is a cardiovascular one and so the treatment of hyperte nsion in the elderly population is an important clinical objective. The cho ice of which antihypertensive drug to prescribe is expanding and an evidenc e-based approach should be applied. In recent years more studies have been carried out into the efficacy of the various antihypertensive drugs in the elderly. This review looks at the "hard" outcome data for each major drug c lass and their suitability for prescribing in the elderly. The differing dr ug classes are divided into 3 categories based on the weight of evidence su pporting them-established, emerging, and add-on therapies. Currently, and u ntil the publication of ongoing trials into newer therapies such as ACE inh ibitors and calcium-channel blockers, outcome data suggests that thiazides remain the drug of first choice except where other therapies are indicated for co-existant conditions or more than one drug is required to achieve the desired response.