Between 1995 and 2005, 196 adults with hypertrophic cardiomyopathy (HCM) were evaluated. Among these, 122 (62%, group 1) patients also had systemic hypertension. The clinical presentation, management, outcome, and echocardiographic findings of these patients were compared with 74 (38%, group 2) patients without systemic hypertension. Patients in group 1 were older at the time of HCM diagnosis and had a higher prevalence of diabetes (28% vs 9%; P=.02) and coronary artery disease (40% vs 25%; P=.03). In addition, echocardiography showed a significantly higher prevalence of systolic anterior motion of the anterior mitral valve in association with dynamic left ventricular outflow obstruction (52% vs 19%; P=.02) and mitral annular calcification (27% vs 13%; P=.03) in group 1 patients. Left ventricular wall thickness (17 mm vs 19 mm), end-diastolic diameter (42 mm vs 42 mm), resting outflow tract gradient >30 mm Hg (17% vs 16%), and ejection fraction (65% vs 64%) were similar in the two groups. HCM frequently coexists with systemic hypertension in the adult population. Presence of systemic hypertension in HCM patients is associated with older age and higher risk of diabetes, coronary artery disease, and noncardiac death.

Peripheral arterial disease (PAD) is defined as an arterial brachial index (ABI) of < or =0.90 in the lower extremities and results from a narrowing of the arteries as a result of progressive atherosclerosis. PAD affects 12-20% of Americans aged 65 years or older; however, most are asymptomatic and many do not seek treatment. Improved awareness and education in both the general population and among health care providers about these modifiable risk factors has the potential to improve general health and decrease morbidity and mortality secondary to atherosclerotic vascular disease.

No abstract

To describe hypertension trends in US adults aged 65 years and older using Medicare Current Beneficiary Survey (MCBS) data, a cross-sectional, nationally representative health examination survey from MCBS files between 1999 and 2004 was investigated. Overall, 62% of beneficiaries, or an estimated 20 million US adults aged 65 years and older, were hypertensive as extrapolated from MCBS data. From 1999 to 2004, the prevalence rate of hypertension increased from 59% to 65% (P<.001). Nonwhite persons and women had a higher prevalence of hypertension than whites and men. A history of diabetes mellitus, prior myocardial infarction, coronary artery disease, or stroke was significantly associated with hypertension treatment. In addition, significant geographic variation in treatment was noted. There was a significant increase in hypertension prevalence in older Medicare beneficiaries from 1999 to 2004. Women, patients 85 years and older, and nonwhite patients were less likely to be treated with antihypertensive medications, and significant geographic variation existed in treatment.