Which of the following trend in blood pressure range is seen with advancement of age from teenage to old age
Answers
Answer:
Isolated systolic hypertension, an elevation in systolic but not diastolic pressure, is the most prevalent type of hypertension in those aged 50 or over, occurring either de novo or as a development after a long period of systolic‐diastolic hypertension with or without treatment. The increase in blood pressure with age is mostly associated with structural changes in the arteries and especially with large artery stiffness. It is known from various studies that rising blood pressure is associated with increased cardiovascular risk. In the elderly, the most powerful predictor of risk is increased pulse pressure due to decreased diastolic and increased systolic blood pressure. All evidence indicates that treating the elderly hypertensive patient will reduce the risk of cardiovascular events. However, there is no evidence yet for the very elderly. This population is particularly susceptible to side effects of treatments and the reduction of blood pressure, although reducing the risk of cardiovascular events such as stroke, may result in increased mortality.
Keywords: ageing, blood pressure, hypertension
An increase in blood pressure (BP) has always been taken as an inevitable consequence of ageing in industrialised societies, leading to hypertension in a high proportion of elderly subjects. However, the characterisation and definition of what constitutes hypertension in the elderly has changed over the years. Data obtained during the Framingham Heart Study, which followed patients for 30 years, agreed that systolic blood pressure (SBP) shows a continuous increase between the ages of 30 and 84 years or over. Diastolic blood pressure (DBP), however, has a varying pattern with ageing, increasing until the fifth decade and slowly decreasing from the age of 60 to at least 84 years of age. This leads to a steep rise in pulse pressure (PP) with ageing.1 Isolated systolic hypertension (ISH) (or simply systolic hypertension as some authors prefer, as the term isolated systolic hypertension may minimise the perceived health risk2) is consequently most prevalent in those aged 50 or over. The third National Health and Nutrition Examination Survey (NHANES III) in the US showed that almost 80% of those individuals aged 50 or over with high BP, at least on a single occasion, have systolic hypertension.3 This and other studies also showed that this type of hypertension was the least well managed, perhaps because it particularly affects the elderly.4 Hypertension in older subjects may be defined as SBP⩾140 mm Hg or SBP⩾160 mmHg and/or a DBP⩾90 mm Hg. Systolic hypertension is either observed de novo or as a development after a long period of systolic‐diastolic hypertension with or without treatment.
Answer:
Isolated systolic hypertension, an elevation in systolic but not diastolic pressure, is the most prevalent type of hypertension in those aged 50 or over, occurring either de novo or as a development after a long period of systolic‐diastolic hypertension with or without treatment. The increase in blood pressure with age is mostly associated with structural changes in the arteries and especially with large artery stiffness. It is known from various studies that rising blood pressure is associated with increased cardiovascular risk. In the elderly, the most powerful predictor of risk is increased pulse pressure due to decreased diastolic and increased systolic blood pressure. All evidence indicates that treating the elderly hypertensive patient will reduce the risk of cardiovascular events. However, there is no evidence yet for the very elderly. This population is particularly susceptible to side effects of treatments and the reduction of blood pressure, although reducing the risk of cardiovascular events such as stroke, may result in increased mortality.
Keywords: ageing, blood pressure, hypertension
An increase in blood pressure (BP) has always been taken as an inevitable consequence of ageing in industrialised societies, leading to hypertension in a high proportion of elderly subjects. However, the characterisation and definition of what constitutes hypertension in the elderly has changed over the years. Data obtained during the Framingham Heart Study, which followed patients for 30 years, agreed that systolic blood pressure (SBP) shows a continuous increase between the ages of 30 and 84 years or over. Diastolic blood pressure (DBP), however, has a varying pattern with ageing, increasing until the fifth decade and slowly decreasing from the age of 60 to at least 84 years of age. This leads to a steep rise in pulse pressure (PP) with ageing.1 Isolated systolic hypertension (ISH) (or simply systolic hypertension as some authors prefer, as the term isolated systolic hypertension may minimise the perceived health risk2) is consequently most prevalent in those aged 50 or over. The third National Health and Nutrition Examination Survey (NHANES III) in the US showed that almost 80% of those individuals aged 50 or over with high BP, at least on a single occasion, have systolic hypertension.3 This and other studies also showed that this type of hypertension was the least well managed, perhaps because it particularly affects the elderly.4 Hypertension in older subjects may be defined as SBP⩾140 mm Hg or SBP⩾160 mmHg and/or a DBP⩾90 mm Hg. Systolic hypertension is either observed de novo or as a development after a long period of systolic‐diastolic hypertension with or without treatment.