Table I.

Guidelines and Hypertension Management in the Elderly

Guidelines	Criteria	Recommended Treatment
JNC 7 9	Target BP <140/90 mm Hg	Diagnosis of hypertension class based on values of SBP and/or DBP Treatment recommendations same as for younger hypertensives
ESH/ESC 2003 12	Target BP <140/90 mm Hg	Anithypertensive treatment in the elderly to follow general treatment guidelines, but gradual approach recommended, especially for frail persons
World Health Organization/International Society of Hypertension 1999 13	Age given as a risk factor for CVD: men >55 years and women >65 years ISH defined as SBP ≥140 mm Hg and DBP ≤90 mm Hg	Recommend treatment for hypertension up to age 80 years Advise caution in the treatment of very elderly, in the absence of sufficient data for those ≥80 years
2001 Canadian Hypertension Recommendations 14	Elderly >60 but <84 years 15 Target BP <140/90 mm Hg	Thiazide diuretics, ARBs, or long‐acting dihydropyridine CCBs recommended as initial therapy for ISH without other compelling indications For very elderly, treatment should be cautious and individualized 15
Scottish Intercollegiate Guidelines Network 16	Blood pressure check recommended for patients >75 years Need for identification of at‐risk patients in 60–75 years age group Full assessment of cardiovascular risk Target BP: <140/90 mm Hg	Lifestyle changes Low‐dose thiazide diuretics, β blockers, ACE inhibitor (no renal artery stenosis present), CCBs (avoid short acting) indicated as first line therapy ARB as alternative to ACE inhibitor if cough is present as adverse effect
JNC=Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; BP=blood pressure; SBP=systolic blood pressure; DBP=diastolic blood pressure; ESH/ESC=European Society of Hypertension/European Society of Cardiology; CVD=cardiovascular disease; ARB=angiotensin receptor blocker; CCB=calcium channel blocker; ISH=isolated systolic hypertension; ACE=angiotensin‐converting enzyme