What is the recommended first-line treatment for hypertension in older adults?

Lifestyle modifications, including diet and exercise, are considered the recommended first-line treatment for hypertension in older adults because they address the underlying factors contributing to high blood pressure without immediate reliance on medication. These modifications can significantly lower blood pressure and reduce cardiovascular risk factors through improvements in overall health.

Prominent lifestyle changes include following the DASH (Dietary Approaches to Stop Hypertension) diet, reducing sodium intake, increasing physical activity, achieving and maintaining a healthy weight, limiting alcohol consumption, and managing stress. For older adults, these non-pharmacological interventions are crucial since they not only help in controlling blood pressure but can also lead to other benefits such as improved mobility, enhanced mood, and better overall health.

While pharmacologic treatments like beta-blockers, ACE inhibitors, and calcium channel blockers are effective, initiating treatment with lifestyle changes is often encouraged before adding medications, especially considering the potential for side effects and drug interactions that may be more pronounced in older populations. Starting with lifestyle modifications also allows for a more holistic approach to managing hypertension.