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Effect of age on response of secondary hypertension to specific treatment
D H Streeten1, G H Anderson, S Wagner
1Department of Medicine, State University of New York Health Science Center, Syracuse.
Insights
Correcting secondary hypertension early, especially before age 40, significantly improves blood pressure outcomes. Delayed treatment in older patients shows less favorable results, highlighting the importance of timely intervention for hypertension management.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Nephrology
Background:
- Secondary hypertension, often correctable, may not always normalize blood pressure.
- Age is a potential factor influencing treatment response in secondary hypertension.
Purpose of the Study:
- To analyze the impact of age on blood pressure response after correcting secondary hypertension.
- To evaluate treatment outcomes in specific secondary hypertension types based on patient age.
Main Methods:
- Retrospective analysis of patients with primary aldosteronism, renovascular hypertension, Cushing's syndrome, and hypothyroid hypertension.
- Comparison of post-treatment blood pressure (diastolic <90 mm Hg) in patients treated before and after age 40.
Main Results:
- Correction of secondary hypertension before age 40 led to normalization of diastolic blood pressure in 24/25 patients.
- In patients over 40, 23/61 (38%) had persistent hypertension (diastolic >90 mm Hg) post-treatment.
- A significant correlation was found between age and post-treatment blood pressure levels.
Conclusions:
- Early correction of secondary hypertension, particularly before age 40, is crucial for achieving normal blood pressure.
- Age significantly influences the effectiveness of interventions for secondary hypertension.
- Timely management of secondary hypertension is vital for long-term cardiovascular health.
Abstract:
There is substantial evidence to show that correction of the causes of secondary forms of hypertension usually but certainly not always restores blood pressure to normal. We have analyzed the effect of age on the response of the blood pressure to the removal of the cause of hypertension in groups of patients with primary aldosteronism, renovascular hypertension, Cushing's syndrome and hypothyroid hypertension. In the patients studied, surgical or medical elimination of the mechanism responsible for the hypertension when the patients were below the age of 40 reduced diastolic blood pressure 1 to 2 years later to below 90 mm Hg in 24 of 25 patients. In the patients who were treated when they were over 40 years of age, blood pressure remained above 90 mm Hg after corrective treatment in 23 of 61 individuals (38%). In the 4 groups studied there was a significant correlation between age and post-treatment systolic and/or diastolic blood pressure. The findings indicate the importance of correcting secondary hypertension at an early age.