Chart 14.1. – Hypertension treatment recommendations for older adults.

	Office SBP		Office DBP
Global condition 1	Treatment threshold	Blood-pressure target 4 , 5	Treatment threshold	Target 8
Healthy 2	≥140 (I, A)	130-139 (I, A) 6	≥90	70-79
Frail older adults 3	≥160 (I, C)	140-149 (I, C) 7	≥90	70-79

1: functional status is more important than chronological age; 2: including light frailty; 3: moderate to severe frailty; 4: including older adults with comorbidities: DM, CAD, CKD, stroke/TIA (not acute stage); 5: actively assess tolerability, including possible atypical symptoms; 6: stricter target (125-135 mm Hg) may be achieved in selected cases, especially for motivated older adults, < 80 years old, with optimum treatment tolerability; 7: higher limits in case of limited survival and absence of symptoms. BP reductions should be gradual; 8: DBP = avoid < 65-70 mm Hg in clinically manifested CAD patients. Note: out-of-office BP monitoring (ABPM/HBPM) should follow changes to the therapy regimen or be performed annually due to greater variability in BP with age, higher risk of orthostatic hypotension, and lower tolerability to inadequate treatment of white coat and masked hypertension.