Blood pressure control essential for elderly patients
It’s common to see hypertension as we age and for years the medics were unsure how to treat this medical condition in elderly people. Hypertension was associated to aging and was often considered as one of the inexorable consequences of the process.
It was confusing to see how they were uncertain about the ways and efficacy of the treatment they prescribed to the older patients. Many older patients weren’t getting the adequate treatment and suffered from unnecessary health complications that could have easily be avoided if they were treated properly.
Thankfully nowadays the thinking has been changed. Years of study and research helped to gather well documented knowledge that clearly indicates that there is a direct link to the hypertension and the risk of death from ischemic heart disease and stroke in patients of all ages.
Therefore, once the patient is diagnosed with high blood pressure, the treatment should begin right away according to the optimal level of blood pressure should be achieved.
To find the possible connection between hypertension and aging long running Framingham study was carried out since 1948. This is the most comprehensive study supported by the National Heart, Lung and Blood Institute and Boston University, and for now it includes three generations of families.
According to the findings of the study, 90% of the people who do not have a visible signs of blood pressure at the age of 55 will develop hypertension during their life.
One of the most important findings of the Framinghan study is that there is continuous, consistent and independent of other risk factors relationship between elevated blood pressure and cardiovascular disease
“The higher the blood pressure is, the greater the chance of getting heart failure, stroke and kidney disease” said the researchers.
Isolated systolic hypertension is the most common form of hypertension in people above 50.
The Journal of the American Medical Association reported in 1991 the results of well known the “Systolic Hypertension in the Elderly Program” which clearly identified that controlling of this form of hypertension can noticeable reduce the risk of stroke and heart related events in older people.
The “Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure” released a new recommendations calling for lower blood pressure readings for all age groups in 2003.
“The therapy should not be withheld on the basis of age” – concluded the researchers.
The strongest evidence that antihypertensive treatment is effective and helps people in age over 80 was provided by in 2008 by one of the largest studies called HYVET — “The Hypertension in the Very Elderly Trial”.
Hypertension in the Elderly Research
HYVET was a unique and the largest clinical trial conducted ever that randomized, double-blind, placebo-controlled study in Europe, China, Australia and Tunisia.
To address the question, how to treat hypertension in elderly people, about 4,000 patients enrolled to the study, aged of 84 and 173/91 mean blood pressure reading.
To reach a target blood pressure of 150/80 one group of patients were treated with 1.5 mg indapamide SR (2 mg to 4 mg of Perindopril as an addition if necessary) when strokes were the primary end point.
It’s of interest the fact that after two years of treatment, participants who took the medications had lower mean blood pressure 15.0/6.1 respectively than in those who was given placebo.
Furthermore, as a result of the treatment significant reduction in the cardiovascular events was absorbed also:
* 30% reduction in strokes, both fatal and nonfatal
* 21% reduction in death from any cause
* 23% reduction in death from cardiovascular causes
* 64% reduction in the rate of heart failure
According to the thorough study and analysis of the research data researchers strongly recommend a target blood pressure of 150/80 in this age group. However, there is more study and required to establish the benefit of further reduction in blood pressure.