Pharmacotherapy of Hypertension and Diabetes Comorbidity in the Elderly: A Narrative Review

Abstract

Introduction: Ageing is a normal physiological process, and with improving healthcare and standard ofliving, the elderly population is projected to increase substantially over time. Hypertension occurs in up to80% of type 2 diabetes cases, and co-morbidity between the two conditions is common among the elderly,posing significant challenges in clinical management. If not adequately addressed, this co-morbidity canlead to increased mortality and complications such as retinopathy, neuropathy and nephropathy.Materials and Methods: This narrative review searched Google Scholar, ResearchGate, PubMed andScopus for literature on the pharmacotherapy of hypertension and diabetes co-morbidity published up toMay 2025. A total of 117 articles meeting the inclusion criteria were selected and analysed.Results: The review describes the pathophysiology of and interactions between hypertension anddiabetes, the complications arising from their co-morbidity, and the clinical guidelines andpharmacological strategies used in their management. Treating elderly patients with both conditionsrequires a nuanced, multidisciplinary approach, as age-associated alterations in drug metabolism,polypharmacy, frailty and comorbid conditions must all be considered to avoid adverse outcomes andpromote adherence while ensuring optimal efficacy.Conclusion: Effective management of hypertension and diabetes co-morbidity in the elderly requiresindividualised, multidisciplinary care guided by current clinical guidelines, with emerging approaches suchas personalised medicine and telemedicine offering promise for improving outcomes in this population.