Hypertension (defined as a blood pressure over 140/90 mm Hg) affects more than two out of three individuals over 75 years of age. However, there has been a tendency not to treat these elevations inblood pressure with blood pressure lowering (anti-hypertensive) medications. This tendency is largely due to a common misconception that a normal systolic pressure is "100 plus your age." Thus, basedon this mistaken idea, a systolic blood pressure of 170 in a 70-year-old person would wrongly be considered normal. Furthermore, there is the valid consideration that a too rapid or too great of areduction of blood pressure may be poorly tolerated in older people. In fact, studies have shown that mild hypertension is often not treated in this age group. For example, only 25 % of patients withsystolic pressures as high as 180-185 mm Hg currently are being treated.
To look further at the significance of this situation, Dr. Moser reviewed the results of several large treatment trials. Hecollected information on more than 700 octogenarians with hypertension who were treated with blood pressure lowering medications. These data were compared to the data in a similar number of octogenarianswho were not treated.
Analysis of the data revealed that treatment with blood pressure lowering (anti-hypertensive) medications reduced the risk for strokes and heart failure by 35%. Further, theincidence of other cardiovascular events (for example, heart attacks) was reduced by 20%. In addition, Dr. Moser pointed out that in these large studies, the blood pressure did not consistently reach agoal of less than 140/90. Nevertheless, an average reduction in systolic pressure of only 12-15 mm Hg was enough to achieve these cardiovascular benefits.
When treating the elderly for hypertension, itis also necessary to consider the other medical conditions that they may have. Some of these conditions may make the patients more prone to side effects from the medications. However, modifying the...
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