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Geriatric Problems

Selected Geriatric Problems

QuestionAnswer
The aging CV system Decreased atrial compliance, increased S BP, loss of beta-adrenergic responsiveness, lowered barorecptor sensitivity, CO decreased with exercise compared to younger people
___ % of pts 75 and over have HTN 70%
HTN also associated with vascular dementia, stroke, erectile dysfunction adn nephropathy
Isolated systolic HTN is common in elderly and is a predictor of adverse CV events“underwear theory” of arterial stiffness leads to inflammation, fibrosis, smooth muscle hypertrophy
___ is a greater predictor of adverse events than SBP or DBP Widened Pulse Pressure; >40
___ study showed that people over 80 with a SBP equal or greater to 160 benefit greatly from a thiazide diuretic and ACEI HYVET
Treatment of the group of older pts with SBP <160 is controversial
Prevalence of postprandial HTN in elderly. 26%. possibly due to blood being pulled into the splanchnic vessels
Tx of HTN in elderly First line: Thiazide diuretics. Then BB, ACEI or ARB, CCBs
Common AE of BB depression
Avoid Thiazide's in pts with renal failure, incontinence
Choose _____ for pts with CHF, DM, CRF ACEI or ARB
Avoid BB in pts with COPD, claudication, conduction, abnormalities, depression
how to treat HTN in patients with BPH May use alpha blockers
Atypical presentation of Coronary Artery Disease Dyspnea, Fatigue, Acute confusion, Chest Pain may not occur
Created by: ltm12
 

 



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