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[Current aspects of arterial hypertension: hypertension in the aged]
1Service de Médecine Interme Gériatrique et Université Paris Nord, Hôpital René Muret-Bigottini, Sevran.
Insights
Hypertension affects over 5 million older adults in France, with over 3 million needing treatment. Antihypertensive therapy significantly reduces mortality and vascular event risks in elderly patients.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Public Health
Context:
- Hypertension prevalence in France among individuals over 65 years old is high, affecting an estimated 5 million people.
- A significant portion, over 3 million, require antihypertensive therapy based on a systolic pressure threshold of 160 mmHg.
- Aging leads to arterial stiffening and other vascular changes, influenced by factors like diet and sodium intake.
Purpose:
- To highlight the high prevalence of hypertension in the elderly French population.
- To underscore the necessity of antihypertensive therapy for a large segment of this demographic.
- To emphasize the benefits of active antihypertensive treatment.
Summary:
- Elderly individuals in France experience high rates of hypertension, necessitating therapeutic intervention for millions.
- Arterial stiffening due to aging, alongside lifestyle factors, contributes to hypertension in this age group.
- Effective antihypertensive therapy is associated with substantial reductions in mortality and cerebrovascular and cardiac events.
Impact:
- Provides crucial data on hypertension prevalence in the French elderly, informing public health strategies.
- Reinforces the importance of timely and appropriate antihypertensive treatment for reducing morbidity and mortality.
- Offers insights into diagnostic considerations and therapeutic modalities for managing hypertension in older adults.
Abstract:
HIGH PREVALENCE: In France, an estimated 5 million persons aged over 65 years have hypertension. Accepting a treatment threshold of systolic pressure 160 mmHg whatever the diastolic pressure, more than 3 million require antihypertension therapy.
Pathophysiology:
During the aging process, the arterial trunks progressively loose their elasticity, becoming more and more rigid. Other age-related modifications of the vascular bed, as well as environmental factors (diet, sodium intake) also play a role.
Useful Treatment:
Several meta-analyses have demonstrated that active antihypertensive therapy can reduce overall mortality by 12%, the risk of cerebral vascular events by 36% and cardiac events by 25%. The risk of non-fatal cerebral vascular events can be reduced by 35%.
Positive Diagnosis:
Repeated blood pressure measurements are needed. Measurements should be made well after meals and take into account possible overestimation related to the rigidity of the humeral artery.
Therapeutic Modalities:
Moderate salt intake and antihypertension drugs should be prescribed. A single drug regimen can be advised for initial treatment, avoiding long-action or high-dose regimens. Episodes of hypotension should be suspected if patients complain of malaise.