Specific aspects of high blood pressure in the elderly
In the elderly, as in the middle-aged, hypertension is a major risk factor for cardiovascular (CV) morbidity and mortality. Hypertension has an increased prevalence in the elderly and has a specific haemodynamic pattern involving four main particularities: increased pulse pressure (PP), resulting fr...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi - SAGE Publishing
2002-03-01
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| Series: | Journal of the Renin-Angiotensin-Aldosterone System |
| Online Access: | http://jra.sagepub.com/content/3/1_suppl/8.full.pdf |
| Summary: | In the elderly, as in the middle-aged, hypertension is a major risk factor for cardiovascular (CV) morbidity and mortality. Hypertension has an increased prevalence in the elderly and has a specific haemodynamic pattern involving four main particularities: increased pulse pressure (PP), resulting from an increase of systolic blood pressure (SBP) and a decrease of diastolic (DBP); disappearance of PP amplification; early wave reflections; and increased arterial rigidity. All these alterations taken together largely explain why PP, aortic stiffness and wave reflections are nowadays recognised as significant independent predictors of CV risk. Beneficial effects on arterial stiffness and wave reflections have been shown with nitrates, drugs affecting the renin-angiotensin system (RAS), spironolactone and aminoguanidine. The main therapeutic trial demonstrating the role of arterial stiffness in the control of SBP and PP in hypertensive subjects was performed in patients with endstage renal disease undergoing haemodialysis. Optimisation of antihypertensive therapy in the elderly would need a combination of using standard hypertensive drugs at adapted dosages, development of new antihypertensive agents and individualisation of therapy. |
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| ISSN: | 1470-3203 1752-8976 |