Table 1.

The BP target and drug selection in elderly patients

Concomitant diseases	Antihypertensive target and drug recommendation
Stroke	BP‐lowering therapy for patients with acute ischemic stroke should be carefully performed in the first week, and it is suggested to deal with anxiety, pain, nausea, vomiting, and higher cranial pressure first. If BP constantly increases to ≥200/110 mm Hg, antihypertensive drug should be used to reduce BP gradually (the reduction <15% over the first 24 h), and BP changes should be closely observed
	For patients with ischemic stroke eligible for thrombolytic therapy, BP should be controlled within 180/100 mm Hg
	The patient with acute ischemic stroke can restore the antihypertensive drugs which used before the onset of stroke or initiate antihypertensive therapy several days after the onset of the disease when in stable condition and BP consistently >140/90 mm Hg
	The long‐term control target of BP for patients with ischemic stroke is <140/90 mm Hg. In patients with lacunar cerebral infarction recently, a lower level <130/80 mm Hg should be targeted if possible
	Early positive antihypertensive therapy in patients with acute intracerebral hemorrhage may improve the prognosis, and blood pressure can be reduced to 140/90 mm Hg if no contraindications present. Antihypertensive therapy should be initiated when blood pressure ≥180/100 mm Hg with intracranial pressure increased, and the target BP is 160/90 mm Hg
	The target of BP in patients with intracerebral hemorrhage is <130/80 mm Hg
Coronary heart disease	The target of BP control should be <140/90 mm Hg in principle and even < 130/80 mm Hg if can be tolerant. There are greater benefits from beta‐blockers and ACE inhibitors, and ARBs can be chosen when ACEI is intolerant. Calcium antagonists are to be preferred for patients with angina or uncontrolled hypertension. Physicians should be cautious when DBP < 60 mm Hg and closely monitor the BP to achieve the target
Chronic heart failure	The target of BP control is <130/80 mm Hg and <140/90 mm Hg for very elderly patients. Beta‐blockers, ACE inhibitors, diuretics, and aldosterone antagonist are recommended as first choice if no contraindication. ARBs can be chosen when ACEI is intolerant
Renal insufficiency	The target of BP control is <130/80 mm Hg and <140/90 mm Hg for very elderly patients. ACEI and ARBs are recommended as first choice if no contraindication. It is suggested to take drugs from small dosage and monitor the changes of kidney function and potassium. CCB, loop diuretics, and alpha‐ and beta‐blockers can be used for patients with CKD Stage 4 (eGFR < 30 mL/min/1.73 m2),ACEI and ARBs should be used with caution
Diabetes mellitus	The recommendation is to lower BP < 140/90 mm Hg and even <130/80 mm Hg if tolerant, and ACEI and ARBs are recommended as first choice