ABSTRACT
Clinical studies continue to modify our approach to the older hypertensive patient. The pathophysiology of hypertension is now better understood from data derived from ambulatory blood pressure monitoring, the assessment of central arterial pressure and of vascular stiffness. This is altering both the ways we assess, monitor, and treat our older hypertensive patients as well as our choice of pharmacological agents. New data have confirmed the importance of treating the very elderly patient's blood pressure and of modifying the increasing incidence of atrial fibrillation. Resistant hypertension is frequently the result of excessive aldosterone production, a situation easily treated. Several investigators have raised the question of the prehypertensive state and of possible therapy.
Subject(s)
Antihypertensive Agents/therapeutic use , Hypertension/drug therapy , Aged , Aged, 80 and over , Blood Pressure Monitoring, Ambulatory , Drug Therapy, Combination , Humans , Hypertension/complications , Hypertension/diagnosisABSTRACT
Older patients are at high risk for food-drug Interactions. These patients are commonly on multiple medications for chronic medical conditions. Age-related physiologic changes affecting drug absorption, distribution, metabolism and excretion, as well as drug action occur in these patients, and this variability in drug action may be further potentiated by interactions with foods. The most prominent interactions involve drug absorption from the GI tract; however alterations in drug metabolism are also highly significant. Food-drug interactions have been reported amongst a wide range of therapeutic drug classes, including, but not limited to, cardiovascular, psychoactive, anti-infective, endocrinologic, gastrointestinal, and respiratory agents. Health care providers can prevent significant drug therapy-related morbidity by carefully selecting drugs for geriatric patients and thoroughly counseling these patients about drug interactions with the foods they eat.
