SYSTEMIC ARTERIAL HYPERTENSION (SAH) IN ELDERLY PATIENTS: CLINICAL PARTICULARITIES AND APPROACH IN PRIMARY HEALTH CARE (PHC)

Abstract

This chapter presents a literature review on Systemic Arterial Hypertension (SAH) in older adults and the main challenges related to its management in Primary Health Care (PHC). The review compiles data showing that SAH is highly prevalent among the elderly, especially those with lower income and education levels, reinforcing its importance as a public health issue. In this context, the chapter also discusses the physiological changes associated with aging, such as arterial stiffness, reduced vascular compliance, decreased baroreceptor sensitivity, and declining renal function, all of which contribute to increased blood pressure (BP) and a higher risk of cardiovascular complications. Accordingly, current diagnostic criteria and the necessary care in BP measurement are reviewed, along with the complementary use of assessments such as ABPM and HBPM, which help identify masked hypertension, white-coat hypertension, and common BP fluctuations in this age group. The chapter discusses guideline-recommended targets, lifestyle modifications, and indicated pharmacological treatments, including medications available through the Brazilian Unified Health System (SUS). The review also addresses challenges faced in PHC, such as difficulties in access, resource limitations, team overload, and failures in continuity of care. Additionally, it emphasizes the importance of the bond between health professionals and elderly patients, as a trust-based relationship improves treatment adherence and understanding of health instructions. Therefore, it concludes that adequate hypertension control in older adults depends on a comprehensive approach that considers their clinical, social, and functional conditions and is supported by multiprofessional actions and effective public policies aimed at preventing complications and promoting healthy aging.

DOI: https://doi.org/10.56238/sevened2025.037-036