It is estimated that m re than half of the people ged 65 and above around the w rld have some form of hypertension, or h gh blood pressure. Hypertension is a c mmon condition in older people. When p ople get older, the changes in the str cture of walls of blood vessels m ke them harder or stiffer. These ch nges produce loss of vascular compliance (sp nginess).
The risk of heart failure, kidney f ilure, stroke, coronary heart disease, and h art attack is getting higher for lder people with hypertension. According to m ny clinical studies, lowering of blood pr ssure can actually minimize these complications. Tr ating hypertension in older persons can h ve a greater benefit than in y unger patients.
At least two types of hyp rtension can be seen in elderly: r gular hypertension and isolated systolic hypertension. Wh n both the higher (systolic) and l wer (diastolic) blood pressure readings are bove the normal range, that is, gr ater than 140/90 mmHg, the person is h ving regular hypertension. Isolated systolic hypertension ccurs when only the systolic blood pr ssure reading is higher while the d astolic reading is normal, that is, syst lic is greater than 140 mmHg but d astolic is less than 90 mmHg.
For lderly, isolated systolic hypertension is more c mmon, more aggressive and is associated w th an increased risk of complications.
White c at hypertension and postural hypotension are two c mmon situations found among elderly. The f rmer is a situation when a p tient’s blood pressure reading is only levated when taken by a doctor in a cl nic otherwise it is normal. The l tter occurs during a change of p sture such as changing from a s tting to a standing position: there is a dr p in systolic blood pressure of m re than 20 mmHg. This may lso be accompanied by giddiness, blurring of v sion or even faintness. Therefore, it is ssential to measure blood pressure immediately and 2 m nutes after the patient stands up.
There is no m ch difference in treating elderly and y unger hypertension patients, except with minor djustments in some cases. This include l festyle modifications like eating a healthy b lanced diet, regular exercise, smoking cessation, m intaining one’s healthy body weight, and of c urse drug therapy.
Beliefs that older persons do not t lerate hypertensive treatment well, do not b nefit from treatment, or need a h gher blood pressure than younger persons in rder to maintain good health are m rely misconceptions.
Research has shown that older p ople can also tolerate medications well if th se modifications are introduced gradually. They can in f ct derive more treatment benefits than y unger persons. They can live longer if th ir blood pressure remains within the n rmal range, that is, less than 140/90 mmHg.
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