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Hypertension in the elderly

A R Dyer, J Stamler, R B Shekelle

    The Medical Clinics of North America
    |May 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

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    Classical hypertension is a significant cardiovascular risk factor in older adults and effectively managed with medication. Treatment benefits outweigh risks, but pure systolic hypertension in the elderly requires more research.

    Area of Science:

    • Gerontology
    • Cardiology
    • Pharmacology

    Background:

    • Classical hypertension (diastolic blood pressure ≥ 95 mm Hg) is prevalent and a major cardiovascular risk factor in adults over 65.
    • Pure systolic hypertension (systolic blood pressure > 160 mm Hg, diastolic < 95 mm Hg) is common in the elderly and linked to cardiovascular issues, possibly due to arterial sclerosis.

    Purpose of the Study:

    • To evaluate the significance of classical and pure systolic hypertension in older adults.
    • To assess the efficacy and risks of antihypertensive therapy in elderly patients.

    Main Methods:

    • Analysis of available data on hypertension prevalence and cardiovascular risk in the elderly.
    • Review of Veterans Administration studies on antihypertensive therapy in elderly patients.

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    Main Results:

    • Classical hypertension in the elderly is a significant risk factor, comparable to younger adults.
    • Antihypertensive therapy for classical hypertension in the elderly is beneficial, with advantages outweighing risks, especially for diastolic pressures ≥ 105 mm Hg.
    • The relationship between pure systolic hypertension and cardiovascular outcomes in the elderly is unclear, potentially a marker of arterial stiffness.

    Conclusions:

    • Elderly patients with classical hypertension can be effectively treated, reducing cardiovascular morbidity and mortality.
    • Careful drug management is crucial to minimize risks like hypotension in elderly patients.
    • Further research is needed on the benefits of treating pure systolic hypertension in older adults due to insufficient data.