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Hypertension in older adults
1Hôpital Broca, CHU Cochin-Port-Royal, Paris, France.
Insights
Hypertension is common in older adults and contributes to serious health issues. Treating both systolic and diastolic hypertension in seniors reduces cardiovascular and cerebrovascular complications, though treatment in the very old remains uncertain.
Area of Science:
- Geriatrics
- Cardiology
- Public Health
Background:
- Hypertension affects nearly half of individuals aged 60 and older, necessitating physician attention.
- Isolated systolic hypertension and elevated pulse pressure are significant risk factors for cardiovascular and cerebrovascular diseases in older adults.
Purpose of the Study:
- To review the importance of hypertension recognition and treatment in older populations.
- To highlight the role of systolic and diastolic hypertension in cardiovascular and cerebrovascular disease development.
- To discuss the evidence for treating hypertension in older adults and identify areas of uncertainty.
Main Methods:
- Review of controlled, randomized trials on hypertension treatment in older adults.
- Analysis of the impact of isolated systolic hypertension and elevated pulse pressure on health outcomes.
- Examination of cardiovascular and cerebrovascular complication rates in treated versus untreated hypertensive elderly patients.
Main Results:
- Treatment of systolic and systolodiastolic hypertension demonstrably decreases cardiovascular and cerebrovascular complications in older adults.
- Isolated systolic hypertension and elevated pulse pressure are implicated in major causes of mortality and morbidity in those over 65.
Conclusions:
- Hypertension management is crucial for reducing adverse cardiovascular and cerebrovascular events in the elderly population.
- Evidence supports the treatment of systolic and systolodiastolic hypertension in older adults.
- Further research is needed to determine optimal hypertension management strategies for individuals over 80 years old.
Abstract:
The high prevalence of hypertension in older persons (nearly one of two subjects aged 60 years and older) suggests that the recognition and treatment should be a priority for physicians. Although diastolic blood pressure is regarded as an important risk factor, it is now clear that isolated systolic hypertension and elevated pulse pressure also play an important role in the development of cerebrovascular disease, congestive heart failure, and coronary heart disease, which are the major causes of cardiovascular morbidity and mortality in the population aged older than 65 years. Controlled, randomized trials have shown that treatment of systolic as well as systolodiastolic hypertension decreases the incidence of cardiovascular and cerebrovascular complications in older adults. The question of whether treatment of hypertension should be maintained in very old persons, those older than 80 years, is still undecided.