Systolic Hypertension in Older Persons

Nature or nurture; BMI and blood pressure at 90. Findings from the Belfast Elderly Longitudinal Free-living Aging STudy (BELFAST)

“…The findings in the BELFAST ‘oldest old’ are similar to results in middle-aged people that link weight and/or anthropometric markers with hypertension (Siani et al 2002, Chaudrey et al 2004). In animals, evidence links obesity with altered blood pressure-natiuresis and increased salt sensitivity.…”

“…Blood pressure was measured only once by Hawksley random-zero sphygmomanometer, which may give lower estimates of blood pressure (Brown et al 1997) compared with the less favored mercury sphygmomanometer. Only about 30% of the ‘oldest old’ in the BELFAST cohort were in the upper incremental third of the systolic and diastolic blood pressure consistent with hypertension, compared with 60% of older populations elsewhere (Chaudrey et al 2004), and this may reflect a recruitment strategy that selected an ‘elite’ rather than an ‘all comer’ octo/nonagenarian cohort (Rea et al 2000). Differing subject numbers and variables measured—a real issue for research participants and their relatives in this challenging age group (Samuelson et al 2008)—may also have reduced the overall statistical power, particularly for male subjects.…”

Prevalence, awareness, treatment, and control of hypertension in the elderly: the Three City study

“…We used this 'old' definition of hypertension as it was still in use at the time the study was performed (March 1999-March 2001, in agreement with the recommendations issued at that time by the French Ministry of Health (ANAES) stating that patients over 65 years of age had to be medically treated only if their SBP was over 160 mmHg [7]. Furthermore, a recent review of the literature on systolic hypertension -the most frequent form of hypertension in the elderly -concluded that the evidence to support treatment of older patients having a SBP between 140 and 159 mmHg remained weak [8]. Finally, the blood pressure level is better assessed with repeated measurements over time.…”

The Role of Pulse Pressure in the Hemodynamic Control of Hypertension: Exploring the Link to Cardiovascular Remodeling

“…Prevalence of hypertension among the elderly is systolic hypertension (Chaudhry et al 2004) due to arterial stiffness resulting in increased pulse pressure (Safar et al 2003;Lakata and Levy 2003;Mitchell et al 2004). …”