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[Arterial hypertension in the elderly. Experience at a hospital service]
L Carvalho1, F Gonçalves, J G Clara
1Serviço de Medicina I., Hospital de Santa Maria, Lisboa.
Insights
Elderly patients with high blood pressure experienced reduced blood pressure and improved cognitive function after a year of treatment. This study highlights the benefits of specialized outpatient care for hypertension in older adults.
Area of Science:
- Geriatrics
- Cardiology
- Public Health
Context:
- Aging populations face increasing cardiovascular disease risks.
- Hypertension is a major public health concern in the elderly.
- Effective management strategies for elderly hypertension are crucial.
Purpose:
- To assess the impact of a specialized outpatient follow-up program for elderly hypertensive patients.
- To evaluate the efficacy of angiotensin converting enzyme inhibitors, calcium channel blockers, or combination therapy.
- To monitor changes in blood pressure, renal function, cardiac dimensions, and cognitive abilities.
Summary:
- A one-year outpatient program treated 61 elderly patients (average age 71) with hypertension using ACE inhibitors, CCBs, or both.
- Mean blood pressure decreased by 15 mm Hg without renal function decline.
- Echocardiography showed reduced left ventricular dimensions, and patients reported improved attention, concentration, and memory.
Impact:
- Specialized care can effectively manage hypertension in the elderly.
- Treatment improved cardiovascular parameters and cognitive function.
- The program maintained mental health status, with no increase in depression rates.
Abstract:
High blood pressure in the elderly population is currently one of the most important public health problems. In recent years, a dramatic increase in life expectancy has occurred and cardiovascular diseases are now one of the major causes of morbidity and mortality in this age group. Therefore, high blood pressure in the elderly has been the aim of many trials throughout the world. In Medicine Department 1 of St. Maria Hospital, we designed and implemented a special outpatient follow-up for elderly people (> or = 65 years old) with hypertensive disease. At the end of the first year, 61 patients (22 men and 39 women) with an average age of 71 years (SD +/- 5.3), with known of high blood pressure for an average of 10 years were treated with angiotensin converting enzyme inhibitor (11 patients), calcium channel blockers (6 patients), or a combination of both drugs. The mean blood pressure fell 15 mm Hg (SD +/- 19.6) without deterioration of the renal function. The echocardiographic evaluation showed reduction in the left ventricular dimensions without significant modifications of diastolic, systolic and cardiac output. In addition, there was a significant increase in attention/concentration and memory abilities, however the percentage of depressed patients was the same at the end of the first year of treatment for high blood pressure.