[The effects of antihypertensive therapy on the aged--an intervention study in a home for the aged]

Excessive antihypertensive therapy can create a risk of brain damage in the aged. Furthermore, no conclusion has been reached regarding treatment goals for systolic blood pressure (SBP). Two hundred elderly people with hypertension (SBP greater than 170 mmHg, average age 74 years) were studied, among them 40 age-sex matched pairs (80 people) were selected for further examination. They were then divided into two groups, and antihypertensive therapy was conducted on each group with systolic blood pressure level goals of 140 mmHg and 160 mmHg, respectively. To set a goal for antihypertensive therapy, we examined Hasegawa's dementia rating scale (HDS) and bilateral common carotid arterial blood flow (CCF), which were measured using the Doppler method. In the group in which the blood pressure was reduced to 160 mmHg level, changes were observed only in right CCF, and there was no change in HDS, but in the group in which the blood pressure was reduced to the 140 mmHg level, changes were observed in both bilateral CCF and HDS. It is recommended that the systolic blood pressure should be set at the 160 mmHg level to maintain the psychological function in the elderly.