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Overdiagnosis of hypertension in the elderly
C Wittenberg1, J R Zabludowski, J B Rosenfeld
1Institute of Nephrology and Hypertension, Beilinson Medical Center, Petah Tikva, Israel.
Insights
Ambulatory blood pressure monitoring (ABPM) helps identify elderly hypertensive patients with normal blood pressure during daily activities, despite clinic readings. This aids in accurate diagnosis and treatment decisions for older adults.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Clinical Diagnostics
Background:
- Elderly hypertensive patients often present with elevated blood pressure readings solely within a clinical setting.
- Accurate blood pressure assessment is crucial for effective management of hypertension in older adults.
Purpose of the Study:
- To evaluate the utility of 24-hour ambulatory blood pressure monitoring (ABPM) in elderly hypertensive patients.
- To determine if ABPM can differentiate between clinic-elevated and true hypertension in this population.
Main Methods:
- Fifty-three hypertensive patients aged 65 years or older (17 untreated, 36 treated) underwent 24-hour ABPM.
- Patients were monitored during their usual daily activities.
Main Results:
- A significant proportion of both untreated (65%) and treated (64%) elderly patients were found to be normotensive during daily activities via ABPM.
- Clinic blood pressure readings did not consistently reflect daytime blood pressure in this cohort.
Conclusions:
- Ambulatory blood pressure monitoring is a valuable tool for elderly hypertensive patients.
- ABPM assists in identifying individuals with "white-coat hypertension" and refining diagnostic and therapeutic strategies in older adults.
Abstract:
Seventeen untreated and 36 treated hypertensives aged 65 years or more were referred to our clinic because of repeated values of systolic blood pressure > or = 160 mmHg and diastolic blood pressure > or = 95 mmHg. All 53 patients underwent 24h blood pressure monitoring during their customary daily activities. Eleven (65%) untreated and 23 (64%) treated patients were normotensive during their daily activities. Thus, ambulatory BP monitoring appears to be useful in the elderly hypertensive patients in detecting those whose BP is elevated only in the clinic. Ambulatory BP obtained outside the clinic may be useful in diagnostic and therapeutic decision-making in the elderly population.