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Blood pressure regulation during the aging process: the end of the 'hypertension era'?

Athanase Benetos1, Paolo Salvi, Patrick Lacolley

  • 1Department of Geriatrics, University Hospital of Nancy, INSERM U961, University of Nancy, Vandœuvre-lès-Nancy, France. a.benetos@chu-nancy.fr

Journal of Hypertension
|December 16, 2010
PubMed

Insights

Standard blood pressure measurements are inadequate for assessing cardiovascular risk in the elderly. New arterial measurements offer a more reliable approach to evaluating arterial risk in aging populations.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Vascular Biology

Background:

  • The traditional understanding of hypertension in the elderly is outdated due to demographic, technological, and therapeutic shifts.
  • Standard blood pressure measurements may be insufficient or misleading for assessing cardiovascular risk in older adults.

Purpose of the Study:

  • To critically evaluate the meaning and determinants of measured blood pressure during aging.
  • To explore alternative methods for assessing arterial risk in the elderly population.

Main Methods:

  • Review of current literature on blood pressure measurement and cardiovascular risk assessment in the elderly.
  • Analysis of direct arterial measurements, including central and peripheral arterial waveforms and pulse wave velocity.

Main Results:

  • Standard blood pressure measurements are inadequate for evaluating cardiovascular risk in the elderly.
  • Direct arterial measurements (e.g., pulse wave velocity) are reliable alternatives for assessing arterial risk.
  • Clinical data support the association of these new measurements with cardiovascular risk and their potential for treatment monitoring.

Conclusions:

  • A transition to advanced arterial measurements is necessary for accurate cardiovascular risk assessment in the elderly.
  • New hemodynamic and vascular biology insights challenge the traditional definition of hypertension based solely on blood pressure values.
  • Direct arterial measurements represent a more integrative and reliable approach to managing arterial risk in aging individuals.

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