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A review of hypertension in the elderly
1Department of Medicine, Ogun State University Teaching Hospital, P.M.B. 2001, Sagamu, Nigeria. flourish@steineng.com
Insights
Hypertension in the elderly is linked to structural vessel changes like reduced aortic compliance and atherosclerosis. Understanding these mechanisms guides physicians in selecting effective antihypertensive treatments to lower peripheral resistance.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Pharmacology
Background:
- Elderly hypertension presents unique pathophysiological mechanisms.
- Systolic blood pressure is a key cardiovascular risk factor, but diastolic pressure also predicts risk.
- Aortic compliance reduction and atherosclerosis are primary contributors to hypertension in older adults.
Purpose of the Study:
- To review current information on hypertension in the elderly.
- To assess the applicability of study designs to managing at-risk patients.
- To guide physicians in making appropriate treatment decisions for elderly hypertension.
Main Methods:
- Literature review of available information on hypertension in the elderly.
- Analysis of study designs and their applicability to clinical management.
- Examination of pathophysiological mechanisms underlying hypertension in this demographic.
Main Results:
- Increased peripheral resistance is a consistent finding in hypertensive elderly patients.
- Structural vascular changes, including decreased aortic compliance and atherosclerosis, are predominant.
- Both systolic and diastolic blood pressure remain significant risk predictors.
Conclusions:
- Understanding the pathophysiological basis of hypertension in the elderly is crucial.
- Treatments targeting peripheral resistance, such as vascular smooth muscle relaxants or alpha-adrenergic blockers, are indicated.
- This review aims to inform clinical decision-making for managing hypertension in older individuals.
Abstract:
The purpose of the paper is to review available information on hypertension in the elderly. Study design applicability of the results to management of patients at risk. Although systolic blood pressure is the strongest cardiovascular risk factor in the elderly, diastolic blood pressure continues to be an independent risk predictor. Structural changes in the major vessels play a predominant role in the pathogenesis of hypertension in the elderly. Such changes include a decrease in aortic compliance and atherosclerosis. The most consistent cardiovascular physiologic change in elderly patients with hypertension is increased peripheral resistance. The most appropriate anti-hypertensive agent would decrease peripheral resistance by relaxing vascular smooth muscle or by blocking the peripheral alpha-adrenergic system. It is concluded that a review of the pathophysiologic mechanisms of hypertension in the elderly will guide physicians in making appropriate treatment decisions.