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Categories of hypertension in the elderly and their 1-year evolution. The Three-City Study

Cécilia Cacciolati1, Olivier Hanon, Carole Dufouil

  • 1INSERM, Neuroepidemiology, Bordeaux, France.

Journal of Hypertension
|February 16, 2013
PubMed

Insights

Elderly individuals with high blood pressure readings at home or in the office face an increased risk of developing hypertension within a year. Home blood pressure monitoring is crucial for identifying those at high risk, especially those untreated.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Hypertension Research

Background:

  • White-coat hypertension (WCHT) and masked hypertension (MHT) are conditions where blood pressure readings differ between clinical and home settings.
  • Understanding the long-term risks associated with these conditions in the elderly is crucial for effective management.

Purpose of the Study:

  • To evaluate the 1-year risk of sustained hypertension in untreated elderly individuals with WCHT or MHT.
  • To assess the 1-year risk of uncontrolled hypertension in treated elderly individuals with office or home uncontrolled hypertension (OUHT or HUHT).

Main Methods:

  • A community-based cohort study of 1481 elderly individuals (≥73 years) was conducted.
  • Blood pressure was measured using a consistent device, defining WCHT, MHT, OUHT, and HUHT based on office and home readings, with or without antihypertensive treatment.
  • Sustained hypertension and uncontrolled hypertension were defined by consistent high readings in both settings, with or without treatment.

Main Results:

  • 13% of participants with high office BP and 26% with high home BP developed sustained or uncontrolled hypertension within 1 year.
  • Individuals with high home BP had a seven-fold increased risk (OR = 6.8) compared to those with normal readings in both settings.
  • Untreated individuals, particularly those with MHT, exhibited significantly higher risks (OR(MHT) = 16.8).

Conclusions:

  • Elderly individuals with elevated office or home blood pressure readings face a heightened risk of developing hypertension within one year.
  • The risk is substantially elevated in untreated individuals, especially those with masked hypertension.
  • These findings underscore the importance of home blood pressure monitoring for early detection and management in the elderly population.
Abstract

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