Intensive blood pressure control in the elderly

Professor Bruce Arroll discusses the issues around intensive blood pressure control in the elderly. Bruce is a GP in south Auckland and professor of general practice at the University of Auckland.

Topics

Standard vs intensive blood pressure control in elderly - is there evidence?
SPRINT study participants and general conclusions
Practical outcomes for GPs from this study

Take home messages

SPRINT study indicates that intensive blood pressure management greatly reduces cardiovascular complications and deaths in older adults.
General tips for prescribing hypertensives for frail patients: Start low and go slow. Measure BP when people are standing up.
Consider performing extra testing for electrolyte issues esp with Chlorthalidone, which is an effective diuretic but alters sodiums and potassiums.
Encourage lifestyle based approaches not just medication; exercise, sodium restriction, low alcohol use, quitting smoking.