HIGH BLOOD PRESSURE IN THE ELDERLY

Published 04/10/2011 | 12:31

HIGH BLOOD PRESSURE (hypertension) is a common condition in the population and one which is frequently undetected and treated. In the past it was felt to be of more relevance to younger age groups. However, we now know following on from major European research trials that it is also a significant condition in the elderly (the over 65 age group). We also know that hypertension in this group has some different attributes to the normal pattern seen in younger ages.

There are at least two types of hypertension seen in this group. Classic essential hypertension is when both the systolic (top number) and the diastolic (bottom number) of a blood pressure (BP) reading are above the normal range ( usually less than 140/90).

Isolated systolic hypertension, which is a really common form in the elderly, is where only the top number is high while the lower number is normal ( the upper number greater than 140 and lower number less than 90).

In general, hypertension in the elderly increases the risk for stroke, heart attack, heart failure, kidney failure, and death. However, isolated systolic hypertension is more common, more progressive, and associated with increased risk for these complications in the elderly more than regular hypertension.

But why should the elderly suffer from this form of blood pressure when they never had difficulties with it when younger in age. The answer lies in their blood vessels which become stiffer and more rigid. This causes them to become narrower and it is harder for the heart to pump blood through them. This ends up with their systolic blood pressure in particular rising.

The important thing is however to make sure that the blood pressure readings are accurate. Research has shown that up to a third of single readings taken are falsely high (usually due to anxiety). The modern approach is to run a 24 hour blood pressure monitor to try and eliminate this group. If this confirms that isolated systolic blood pressure is actually present then it is important to treat it.

Treatment as in younger age groups is a combination of lifestyle changes ( diet, exercise and reducing salt), stopping smoking and using drugs to reduce the blood pressure down to normal.

The best advice is if belonging to this age group â?“ have your blood pressure measured either with your doctor or pharmacist. If elevated, your family doctor will investigate further.

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