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Hypertension in the elderly.

V Kulkarni1, N Bhagwat, A Hakim

  • 1Department of Medicine, TN Medical College and BYL Nair Hospital, Mumbai.

The Journal of the Association of Physicians of India
|February 12, 2002
PubMed
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Elderly patients with hypertension often have isolated systolic hypertension (ISH). Uncontrolled blood pressure, ISH, and other risk factors contribute to cardiovascular and cerebrovascular complications in older adults.

Area of Science:

  • Gerontology
  • Cardiology
  • Nephrology

Background:

  • Hypertension is a significant health concern in the elderly population.
  • End-organ damage is a common complication of hypertension in older adults.
  • Understanding the interplay of risk factors is crucial for managing hypertension in the elderly.

Purpose of the Study:

  • To elucidate the clinical characteristics of hypertension in elderly individuals.
  • To investigate the development of end-organ complications associated with hypertension.
  • To assess the combined effect of hypertension and other risk factors on complication development.

Main Methods:

  • A cohort of 136 elderly patients from a Hypertension Clinic was studied.
  • Data collection included detailed medical history, physical examination (including waist-to-hip ratio and fundoscopy), and laboratory tests (RFT, LFT, blood sugar, lipid profile).

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  • Investigations comprised chest X-ray, ECG, 2-D echocardiography, abdominal ultrasound, and CT head scans when indicated.

    • Main Results:

    • Headache was the most frequent symptom (77.9%), though 24 patients were asymptomatic.
    • Obesity, diabetes, alcohol use, dyslipidemia, and family history were key determinants of hypertension.
    • Isolated systolic hypertension (ISH) affected 56.6% of patients, with Grade II hypertensive retinopathy in 29.4% and Left Ventricular Hypertrophy (LVH) in 36.8% (ECG) and 46.4% (2-D echo).
    • Uncontrolled hypertension and ISH correlated with increased cardiovascular and cerebrovascular complications.

    Conclusions:

    • Elderly hypertensive patients frequently exhibit Isolated Systolic Hypertension (ISH).
    • A family history of hypertension is a significant determinant.
    • Uncontrolled hypertension, ISH, Left Ventricular Hypertrophy (LVH), and co-existing risk factors are major contributors to cardiovascular and cerebrovascular morbidity.