Title:Calcium Channel Blockers in the Management of Hypertension in the Elderly
Volume: 12
Issue: 3
Author(s): Francisco J. Caballero-Gonzalez
Affiliation:
Keywords:
Calcium antagonists, hypertension, elderly.
Abstract: The aging population is rapidly increasing, and is mainly due to medical advances and the control of chronic
diseases, with a real worldwide increase in the elderly population. Special emphasis has been placed on the management
of hypertension in the geriatric patient, since its long-term benefits have been shown to prevent both cerebral and cardiac
infarctions.
Calcium channel blockers have been shown to be effective in this condition in the elderly. Their success depends on their
mechanism of action, as well as on the physiological changes observed, and on the aging process itself, which include
cardiac hypertrophy, calcification of cardiac valves, and a decrease in the excitation-conduction system. There is
thickening of the tunica intima of the arteries, and the production of nitric oxide at cellular level decreases with age, along
with an increase in endothelin 1, which leads to vascular endothelium dysfunction. In the kidneys, there is a decrease in
prostacyclin, endothelial hyperpolarization factor, as well as the Klotho anti-aging protein, which leads to an increase in
blood pressure.
Calcium channel blocker drugs have been shown to be effective in any age group for the management of hypertension,
and are safe in the elderly patients. These drugs block L-type calcium channels, with the long-acting or latest generation
dihydropyridines being the most effective of this group. Several studies, including SYST-EUR2, NORDIL, and STOP-2,
have demonstrated the effectiveness of these drugs in the geriatric patient.
The prescribing of long-acting calcium channel blocker drugs in a single dose is the most recommended. The safety in the
use of this drug group has been demonstrated in the treatment of hypertension in the elderly patient, with a level of
effectiveness similar to other widely used drugs.
