Blood pressure poorly
controlled in the elderly, especially women
Newswise — Controlling high blood
pressure in individuals age 80 years and older has become a major
national health problem, according to a study published in the July
27 issue of JAMA.
The study found that almost three
fourths of those 80 years and older have hypertension -- blood
pressure greater than 140 systolic over greater than 90 diastolic.
Fewer than 10 percent have “normal” blood pressure levels -- less
than 120 systolic over less than 80 diastolic.
The research, which was based on
data from the National Heart, Blood, and Lung Institute’s
long-standing Framingham Heart Study, also found that older
hypertensive women are especially at risk for having poorly
controlled hypertension.
Risks for cardiovascular disease
also are substantial in this population, indicating the need for
greater efforts at safe, effective risk reduction among the oldest
hypertensive persons. Among men and women study participants with
the highest levels of blood pressure at age 80 or older, 25 percent
had a major cardiovascular event (heart attack, stroke or
hospitalization for heart failure) within six years’ follow-up.
“Greater public health and
clinical efforts are needed for patients and physicians to improve
awareness of the risks of hypertension, to understand the benefits
and potential risks of treatment and to identify safe and effective
strategies for blood pressure and overall cardiovascular disease
risk reduction in the oldest hypertensive individuals,” said Donald
Lloyd-Jones, M.D., assistant professor of preventive medicine at
Northwestern University Feinberg School of Medicine, who was lead
author on the article.
The very elderly are among the
fastest growing segments of the U.S. population and they have the
highest prevalence of hypertension. It is rare to escape the
development of hypertension with aging: Even for individuals free of
hypertension at age 65, the remaining lifetime risk of developing
hypertension is approximately 90 percent, Lloyd-Jones said.
Despite numerous clinical studies
showing the benefits of lowering blood pressure in older
hypertensive persons, data suggest that rates of treatment and
control are less than optimal and that risks for cardiovascular
disease are substantial, Lloyd-Jones said.
Studies from national surveillance
data, however, are typically limited to adults younger than age 75,
and information regarding current patterns of treatment and control
of high blood pressure among those 80 and older is sparse.
Lloyd-Jones and co-researchers
Jane C. Evans and Daniel Levy, M.D., from the National Heart, Lung,
and Blood Institute analyzed data from almost 5,300 Framingham Study
participants (2,300 men and approximately 3,000 women).
Among the oldest hypertensive
individuals, only 38 percent of men and 23 percent of women had
their blood pressure controlled to recommended levels of less than
140 systolic over less than 90 diastolic.
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