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Epidemiology of hypertension in the elderly
1Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, UK.
Insights
Blood pressure increases with age, affecting many older adults. Treating hypertension in individuals over 60 significantly reduces stroke risk, highlighting the importance of blood pressure management.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Public Health
Background:
- Blood pressure naturally rises with age.
- Hypertension prevalence increases significantly in older adults (60-79 years).
- Factors like diet, weight, exercise, and alcohol influence blood pressure.
Purpose of the Study:
- To summarize the impact of age on blood pressure.
- To review the relationship between blood pressure and health risks.
- To evaluate the effectiveness of hypertension treatment in older adults.
Main Methods:
- Analysis of existing epidemiological data on blood pressure trends.
- Review of clinical trial results for hypertension treatment efficacy.
- Examination of the correlation between blood pressure levels and adverse health outcomes.
Main Results:
- A linear association exists between elevated blood pressure (systolic and diastolic) and increased risk of stroke and coronary heart disease.
- Hypertension treatment in adults over 60 demonstrably reduces stroke incidence by approximately 40%.
- Some studies indicate a reduction in coronary events following hypertension treatment, though this may be less pronounced than stroke reduction.
Conclusions:
- Age-related hypertension is a significant public health concern.
- Effective management of hypertension in older adults is crucial for reducing cardiovascular morbidity.
- While low blood pressure is not typically a mortality risk in the elderly, high blood pressure poses a substantial threat.
Distribution:
Blood pressure tends to rise with increasing age. Six to eight per cent of people aged 60-69 years, and about 12-16% of those aged 70-79 years, are estimated to need treatment for raised systolic and diastolic blood pressures.
Determinants:
It seems likely that the rise in blood pressure with increasing age is partly explained by the determinants of blood pressure, such as sodium intake, body weight, physical exercise and alcohol consumption.
Mortality:
There is a linear relationship between the level of diastolic or systolic blood pressure and the risk of stroke or coronary heart disease. However, the relationship between blood pressure and mortality in later life may be obscured if concurrent illness lowers blood pressure; low blood pressure by itself may not be a risk factor for mortality.
Treatment:
Randomly allocated trials have consistently shown that the treatment of hypertension in men and women over 60 years of age reduces the incidence of stroke by about 40%, and some trials have also shown reductions in coronary events.