Table 1.

Description of steps in hypertension control and relevant considerations for older adults

	Description	Relevance to older adults
Measure	Technique, device, setting	• Proper technique limited by physical and cognitive impairment or geriatric conditions • Competing demands for clinical assessments among older adults with multimorbidity (i.e., proper technique a low priority) • Higher prevalence of treated white coat hypertension at older age
Plan	Setting goals	• Concerns about generalizability of clinical trial evidence for some older adults • Wide range in health goals and willingness to accept tradeoffs between benefits and harms at older age
Treat	Management strategy, benefits vs. harms	• Treatment intensification likely to result in polypharmacy • Physical and cognitive impairment may limit self-management • Dependence on caregivers for self-management support • Falls are a common cause and death and disability in older adults. Fear of precipitating a fall may affect treatment decisions
Monitor	Follow-up over time	• Heterogeneity in life expectancy and time for which BP monitoring may be necessary • Intervening health events and declining function occur at older age and may affect BP control or treatment goals

Abbreviation: BP, blood pressure.