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Profile of hypertension in elderly subjects
S Dwivedi1, G Singh, M P Agarwal
1Preventive Cardiology Clinic UCMS-GTB Hospital, Delhi 110 095.
Insights
Hypertension is a common cardiovascular issue in older adults, often linked with conditions like coronary artery disease and diabetes. Elderly patients with hypertension and left ventricular hypertrophy face a high risk of early mortality.
Area of Science:
- Gerontology
- Cardiology
- Internal Medicine
Background:
- Hypertension is a prevalent cardiovascular disorder in the elderly population.
- Understanding the clinical profile and associated conditions is crucial for managing this demographic.
Purpose of the Study:
- To investigate the clinical characteristics of hypertension in individuals aged 60 and above.
- To identify common comorbidities associated with hypertension in the elderly.
Main Methods:
- A study involving 205 consecutive subjects aged 60+ with cardiovascular disorders.
- 156 subjects were diagnosed with essential hypertension (HTN) and classified using JNC-VI criteria.
- Clinical examinations and laboratory tests were performed to detect associated ailments.
Main Results:
- The majority of patients were between 60-70 years old, with a mean age of 67.36 years.
- Commonly associated conditions included coronary artery disease (57.05%), non-insulin dependent diabetes mellitus (31.41%), and cerebrovascular disease (23.71%).
- Hypertension alone was present in only 19.87% of subjects; 20% of patients with left ventricular hypertrophy (LVH) died within 12 weeks.
Conclusions:
- Hypertension is the most frequent cardiovascular disorder among the elderly.
- Coronary artery disease, non-insulin dependent diabetes mellitus, and cerebrovascular disease are frequently observed comorbidities.
- Left ventricular hypertrophy in hypertensive elderly patients is associated with significantly high short-term mortality.
Objective:
To study clinical profile of hypertension in elderly subjects.
Methods:
Two hundred and five consecutive subjects aged 60 years and above reporting to preventive cardiology clinic with cardiovascular disorders were studied. One hundred fifty six subjects (76.09%) were found to have essential hypertension (HTN). Newly detected hypertensives were classified as per JNC-VI classification. Detailed clinical examination and laboratory investigations were carried out to find evidence of associated ailments with HTN.
Results:
Most of the patients belonged to 60-70 years age group. Mean age was 67.36 +/- 6.23 years (range 60 to 90 years) and male to female ratio was 1.44:1. Out of hypertensives 99 (63.46%) had HTN for long period, while 28 (17.94%), 17 (10.89%) and 12 (7.67%) belonged to mild, moderate and severe HTN categories, respectively. Out of newly detected hypertensives 14 (24.56%) were having isolated systolic HTN. Associated clinical conditions in hypertensives were coronary artery disease (CAD), non-insulin dependent diabetes mellitus (NIDDM), cerebrovascular disease (CVD), left ventricular hypertrophy (LVH) and chronic obstructive pulmonary disease (COPD) in 69 (57.05%), 49 (31.41%), 37 (23.71%), 20 (12.80%) and 10 (6.4%) subjects, respectively. HTN alone was found in 31 (19.87%) subjects only. Since most of these patients had other concomitant illnesses such as CAD. NIDDM etc. therapy was initiated accordingly. Four (20%) patients with LVH died within short period of 1 to 12 weeks.
Conclusion:
HTN is the commonest cardiovascular disorder in elderly subjects. CAD, NIDDM and CVD are commonly associated clinical conditions. Patients with associated LVH have very high short term mortality.