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Rational for Treatment of Hypertension in the Elderly
1Department of Medicine, Section of Preventive Medicine and Epidemiology, Evans Memorial Research Foundation, Boston University School of Medicine, Boston, MA.
Insights
Hypertension significantly increases cardiovascular risks in older adults, even more than other common conditions. Treating high blood pressure in the elderly is highly effective in preventing serious heart problems.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Hypertension is a major risk factor for cardiovascular diseases in the elderly, doubling the risk.
- The risk associated with hypertension in older adults surpasses that of hypercholesterolemia, diabetes, and smoking.
- Despite decreasing risk ratios with age, increased cardiovascular disease incidence leads to greater attributable risk, enhancing treatment cost-effectiveness.
Purpose of the Study:
- To highlight the significant impact of hypertension on cardiovascular health in the elderly.
- To emphasize the prevalence and specific challenges of hypertension management in older populations.
- To underscore the benefits of antihypertensive therapy in preventing cardiovascular events in the elderly.
Main Methods:
- Review of existing antihypertensive trials and epidemiological data concerning elderly populations.
- Analysis of risk factors and comorbidities associated with hypertension in older adults.
- Evaluation of the cost-effectiveness of hypertension treatment in the elderly.
Main Results:
- Approximately 50% of the elderly population has hypertension, with 65% experiencing isolated systolic hypertension (ISH).
- Hypertension frequently coexists with other risk factors like hypercholesterolemia, diabetes, and obesity, increasing overall cardiovascular risk.
- Antihypertensive therapy demonstrates significant benefits in the elderly, particularly for those with ISH, and is proven to be cost-effective.
Conclusions:
- Hypertension poses a substantial and dangerous threat to cardiovascular health in the elderly.
- Effective control of hypertension in older adults is achievable and crucial for preventing adverse cardiovascular outcomes.
- Timely and appropriate antihypertensive treatment in the elderly yields significant benefits in reducing cardiovascular sequelae.
Abstract:
Hypertension is a powerful predisposing factor to the major cardiovascular problems common to the elderly, doubling the risk. This increased risk of cardiovascular events exceeds that associated with the existence of hypercholesterolemia, diabetes, and smoking. The decrease in risk ratio with advancing age is offset by the increased cardiovascular disease incidence, resulting in a greater attributable risk, which makes treatment of hypertension more cost effective in the elderly. The prevalence of hypertension is high in the elderly, with about 50% afflicted; 65% of those patients have isolated systolic hypertension (ISH). Hypertension in the elderly often occurs concomitantly with hypercholesterolemia, diabetes, obesity, hypertriglyceridemia, and left ventricular hypertrophy, all of which enhance the risk. Also, 25% of these patients already have manifest cardiovascular disease. These associated cardiovascular conditions and risk factors determine the urgency for treatment and choice of optimal therapy. Antihypertensive trials indicate greater benefit of antihypertensive therapy in the elderly than in the young and have been shown to clearly benefit those with ISH. Thus, hypertension is dangerous in the elderly, is readily controlled, and treatment can provide great benefit in preventing cardiovascular sequelae.