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[Hypertension in the elderly: What we need to know]
P Fernández-Llama1, N Ayasreh1, F Calero1
1Unidad de Hipertensión y Prevención de Daño Renal, Servicio de Nefrología, Fundació Puigvert, Universitat Autònoma de Barcelona (UAB), Institut d'Investigació Biomèdica Sant Pau, Barcelona, España.
Hipertension Y Riesgo Vascular
|November 26, 2020
Summary
Hypertension affects over two-thirds of adults over 65, presenting unique management challenges. Effective treatment in the elderly significantly reduces cardiovascular risks and overall mortality.
Area of Science:
- Geriatric Medicine
- Cardiovascular Health
- Internal Medicine
Background:
- Hypertension prevalence exceeds two-thirds in individuals over 65.
- Comorbidities contribute to a heterogeneous elderly population regarding functional capacity.
- Aging-related vascular stiffness leads to specific hypertension types, such as isolated systolic hypertension.
Purpose of the Study:
- To highlight the unique characteristics of hypertension in the elderly.
- To emphasize factors influencing blood pressure measurement in older adults.
- To underscore the importance of considering these factors in therapeutic decision-making.
Main Methods:
- Clinical blood pressure measurement.
- Consideration of temporal, environmental, and positional influences on blood pressure.
- Review of evidence regarding hypertension management in the elderly.
Main Results:
- Elderly hypertension management is complicated by factors like isolated systolic hypertension and vascular stiffness.
- Blood pressure readings are influenced by circadian rhythms (e.g., absence of night dipping), the white coat phenomenon, and postural changes (orthostatic hypotension).
- Evidence supports that treating hypertension in this age group reduces cardiovascular morbidity and mortality, as well as all-cause mortality.
Conclusions:
- Specialized considerations are necessary for evaluating and managing hypertension in the elderly.
- Accounting for various influences on blood pressure is crucial for effective therapeutic strategies.
- Treatment of hypertension in older adults is associated with significant reductions in adverse health outcomes.
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