Many hypertensive patients, in the pursuit of new and expensive drugs, often overlook the fact that these choices may not be correct. Although new drugs may have certain effects, their side effects are often unknown, so in terms of safety, new drugs may not be safer than old drugs. Expensive drugs are not necessarily more effective, as the price of medication is influenced by many factors and may not correlate with its efficacy. Now let's take a look at the considerations for elderly hypertensive patients.
1. Adjust medication dosage in a timely manner
Elderly hypertensive patients often experience significant fluctuations in blood pressure, especially systolic pressure. This is mainly due to reduced sensitivity of the pressure receptors in elderly patients' blood vessels. Therefore, blood pressure should be regularly measured during hypertension drug treatment and medication dosage should be adjusted as needed.
2. Use medication cautiously
Elderly hypertensive patients are more susceptible to postural changes and have a higher incidence of orthostatic hypotension, especially during antihypertensive drug therapy, which is also related to reduced sensitivity of the pressure receptors. Therefore, medications that can cause orthostatic hypotension should be used with caution.
3. Gradually lower blood pressure
Elderly hypertensive patients often experience pseudo-hypertension due to arterial stiffness. These patients have poor tolerance to antihypertensive drugs, which can lead to severe adverse reactions and complications. At the same time, the rate of blood pressure reduction in elderly hypertensive patients should not be too fast or too low.
4. Avoid heart diseases
Elderly hypertensive patients are more prone to increased systolic pressure, which poses a greater risk to the heart and increases the likelihood of heart failure. They are also more likely to have strokes.
5. Pay attention to side effects
Elderly patients have reduced reactivity of beta receptors, so they have better tolerance to beta blockers, but there is still a risk of bradycardia and congestive heart failure.
6. Be aware of cardiovascular damage
Elderly patients are more sensitive to decreased blood volume and sympathetic nervous system inhibition, which may be related to cardiovascular reflex damage in the elderly.
7. Start with small doses
The initial and incremental doses of antihypertensive drugs for elderly hypertensive patients should be smaller than those for younger patients, and the interval between doses should be longer.
8. Avoid certain medications
Elderly patients have lower neurologic function and are more prone to depression during medication therapy. Therefore, antihypertensive drugs that act on the central nervous system, such as clonidine, methyldopa, and reserpine, should be avoided.
In order for hypertensive patients to choose the right medication, it is necessary to consider the following four principles: the antihypertensive effect of the drug, its protective effect on the cardiovascular system, the size of its side effects, and its cost-effectiveness.
