Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders
Controlling hypertension has become an important issue in the elderly population in whom neurological comorbidities are highly prevalent. Most of the large-scale trials focusing on hypertension management in older populations have excluded patients with comorbid neurological disorders. However, this...
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| Format: | Article |
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Elsevier
2025-07-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664625000087 |
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| author | Cheng-Hsuan Li Sung-Ju Hsueh Li-Kai Tsai Wei-Hung Chang Shao-Yi Cheng Hao-Min Cheng Chih-Fan Yeh Yen-Hung Lin Hsin-Hsi Tsai |
| author_facet | Cheng-Hsuan Li Sung-Ju Hsueh Li-Kai Tsai Wei-Hung Chang Shao-Yi Cheng Hao-Min Cheng Chih-Fan Yeh Yen-Hung Lin Hsin-Hsi Tsai |
| author_sort | Cheng-Hsuan Li |
| collection | DOAJ |
| description | Controlling hypertension has become an important issue in the elderly population in whom neurological comorbidities are highly prevalent. Most of the large-scale trials focusing on hypertension management in older populations have excluded patients with comorbid neurological disorders. However, this population requires special considerations, as the benefits of antihypertensive agents are mostly uncertain and there is a higher risk of adverse events. In this review article, we discuss current evidence regarding the management of elderly patients with hypertension and common neurological disorders, including stroke and neurodegenerative diseases.In elderly patient with a history of stroke, the blood pressure management strategy is generally similar to that for young patients, however the benefits of stroke prevention from blood pressure control are less significant. For patients with neurodegenerative disorders such as cognitive dysfunction and Parkinson's disease, achieving adequate blood pressure control may be beneficial in reducing cardiovascular risks, although the higher risk of adverse events from antihypertensive treatment may offset some of these benefits. Special considerations for factors such as orthostatic hypotension, risk of falls, polypharmacy, and significant drug-drug interactions are required but frequently neglected in clinical practice. More efforts are warranted to determine the optimal treatment strategy for elderly populations with neurological disorders. |
| format | Article |
| id | doaj-art-e2bf0d53bfcb4cde893afba8ecc97382 |
| institution | DOAJ |
| issn | 0929-6646 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj-art-e2bf0d53bfcb4cde893afba8ecc973822025-08-20T03:12:43ZengElsevierJournal of the Formosan Medical Association0929-66462025-07-01124S55S6210.1016/j.jfma.2025.01.008Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disordersCheng-Hsuan Li0Sung-Ju Hsueh1Li-Kai Tsai2Wei-Hung Chang3Shao-Yi Cheng4Hao-Min Cheng5Chih-Fan Yeh6Yen-Hung Lin7Hsin-Hsi Tsai8Department of Neurology, National Taiwan University Hospital Hsinchu Branch, Hsin-Chu, Taiwan; Department of Neurology, National Taiwan University Hospital, Taipei, TaiwanDepartment of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, National Taiwan University Hospital Bei-Hu Branch, Taipei, TaiwanDepartment of Neurology, National Taiwan University Hospital, Taipei, TaiwanDepartment of Psychiatry, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, TaiwanDepartment of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, TaiwanPh.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Division of Faculty Development, Taipei Veterans General Hospital, Taiwan; Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan; Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, TaiwanDepartment of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Department of Neurology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.Controlling hypertension has become an important issue in the elderly population in whom neurological comorbidities are highly prevalent. Most of the large-scale trials focusing on hypertension management in older populations have excluded patients with comorbid neurological disorders. However, this population requires special considerations, as the benefits of antihypertensive agents are mostly uncertain and there is a higher risk of adverse events. In this review article, we discuss current evidence regarding the management of elderly patients with hypertension and common neurological disorders, including stroke and neurodegenerative diseases.In elderly patient with a history of stroke, the blood pressure management strategy is generally similar to that for young patients, however the benefits of stroke prevention from blood pressure control are less significant. For patients with neurodegenerative disorders such as cognitive dysfunction and Parkinson's disease, achieving adequate blood pressure control may be beneficial in reducing cardiovascular risks, although the higher risk of adverse events from antihypertensive treatment may offset some of these benefits. Special considerations for factors such as orthostatic hypotension, risk of falls, polypharmacy, and significant drug-drug interactions are required but frequently neglected in clinical practice. More efforts are warranted to determine the optimal treatment strategy for elderly populations with neurological disorders.http://www.sciencedirect.com/science/article/pii/S0929664625000087Blood pressureStrokeDementiaParkinson's disease |
| spellingShingle | Cheng-Hsuan Li Sung-Ju Hsueh Li-Kai Tsai Wei-Hung Chang Shao-Yi Cheng Hao-Min Cheng Chih-Fan Yeh Yen-Hung Lin Hsin-Hsi Tsai Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders Journal of the Formosan Medical Association Blood pressure Stroke Dementia Parkinson's disease |
| title | Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders |
| title_full | Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders |
| title_fullStr | Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders |
| title_full_unstemmed | Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders |
| title_short | Blood pressure targets, medication considerations and special concerns in elderly hypertension III: Focus on stroke and neurodegenerative disorders |
| title_sort | blood pressure targets medication considerations and special concerns in elderly hypertension iii focus on stroke and neurodegenerative disorders |
| topic | Blood pressure Stroke Dementia Parkinson's disease |
| url | http://www.sciencedirect.com/science/article/pii/S0929664625000087 |
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