Hypertension is the most important risk factor for cardiovascular events in the elderly, and it is present in more than 50% of the American population over 60 years of age. Both systolic and diastolic blood pressure are directly related to increasing cardiovascular risk and systolic pressure becomes even more important ...

Data from the total urban elderly population (75 years and older) in Kungsholmen, Stockholm, were used to calculate age- and sex-specific prevalence of hypertension. Blood pressure was measured as part of the examination in the population survey (the Kungsholmen Project). The blood pressure of 1751 elderly people and any antihypertensive ...

Heart disease in older individuals can be characterised as the result of 2 processes, hypertension and atherosclerosis, which are the major causes of heart failure in the elderly population. The aging heart undergoes changes at the molecular, cellular and organ levels. These age-related changes may then be modulated by pathological ...

1. The aim of this study was to determine the effects of caffeine on haemodynamic and neurohumoral responses to meal ingestion in elderly patients with a history of symptomatic postprandial hypotension. 2. Postprandial hypotension is a common disorder of blood pressure regulation in the elderly, associated with falls and syncope. ...

Although left ventricular filling tends to occur in late diastole in the elderly, the clinical significance of this change is unclear. To determine the prevalence of diastolic filling delay and its relationship to congestive heart failure (CHF) in the elderly, we studied 114 community-living elderly volunteers (median age 75, 37% ...

In this review article, the authors cover the pathophysiology of elevated blood pressure in the elderly. Isolated systolic hypertension and pseudo-hypertension are noted. Some of the large treatment trials are discussed. Nonpharmacologic and pharmacologic management are covered. Neurologic aspects of hypertension in this population are discussed in some detail. Additional ...

The benefits of treating isolated systolic hypertension (ISH) have been established, but the most appropriate choice of drug is still uncertain. For this reason, a sustained-release formulation of isradipine was compared with spirapril in a double-blind randomized study in elderly Chinese patients with ISH. The dosage was titrated if necessary ...

OBJECTIVE: To assess the prevalence of hypertension and isolated systolic hypertension and the level of awareness, treatment and control of hypertension, in a population aged over 65 years. DESIGN: Cross-sectional survey of the total population aged > or = 65 years of two Bavarian villages with a representative age distribution. ...

OBJECTIVES: To observe blood pressure, cardiovascular events, and total mortality after withdrawing antihypertensive treatment for elderly patients. DESIGN: Multicentre observational study. SETTING: Sweden. A 5-year follow-up of 333 elderly hypertensive patients, aged 70-84 years (mean age 75.2 +/- SD 3.8 years, 68% females). In all, 74 out of the 333 ...

The relationship between calcitrophic hormones and blood pressure has been investigated in 583 elderly subjects who were untreated for hypertension. Univariate analysis demonstrated that serum parathyroid hormone, calcitriol, albumin and calcium were correlated significantly with mean blood pressure (r = +0.15, +0.10, +0.14 and +0.11, respectively), as were body mass ...

Cardiovascular disease remains the major cause of death in elderly people, with hypertension the main treatable risk factor. Despite this there has been little consensus with regard to assessment or treatment of the elderly hypertensive patient. Several recent large intervention trials have shown blood pressure (BP) reduction in elderly patients ...

Hypertension affects most elderly Americans. In eight major randomized, controlled trials evaluating the treatment of hypertension in the elderly, drug therapy for high blood pressure (including isolated systolic hypertension) has been shown to prevent fatal and nonfatal strokes and coronary events. The relative reduction in strokes was greater than that ...

Raised blood pressures in the elderly and the increased prevalence of hypertension in this population are not benign occurrences and should not be viewed as a normal or inevitable consequence of aging. In fact, the relation of systolic and diastolic blood pressures to cardiovascular events is generally more pronounced in ...

To evaluate whether circadian rhythms in blood pressure and heart rate are influenced by age, we analyzed 24-h ambulatory blood pressure and heart rate recordings from 31 patients with primary hypertension. Data were collected during hospitalization, after a drug-free run-in period. Set times were administered for lights-on, meals, and lights-off. ...

Pharmacokinetic and pharmacodynamic data were compared between elderly and young patients with hypertension who received single intravenous doses of amlodipine, a dihydropyridine calcium antagonist, followed by oral administration of amlodipine up to 10 mg once daily for 12 weeks. After intravenous administration, elderly patients had prolonged elimination half-life values (58 ...

The ability of erythrocytes to undergo deformation may be of importance to erythrocyte survival and to blood flow resistance. In a previous study a decreased deformability was demonstrated in the erythrocytes of uraemic patients treated with recombinant human erythropoietin (rhEPO). Erythrocyte deformability is, at least partly, determined by the intracellular ...

Ventricular ectopic activity was recorded at baseline in 5.6% of the 12-lead electrocardiograms and 8.2% of the 2-minute rhythm strips of 4674 subjects with isolated systolic hypertension (systolic blood pressure 160 to 219 mm Hg, diastolic blood pressure < 90 mm Hg) participating in the Systolic Hypertension in the Elderly ...

Numerous reports have accumulated from around the world throughout the twentieth century of small, remote, self-sufficient populations that do not show a rise of blood pressure with age. Knowing that renocortical arteriosclerosis, a defining feature of hypertensive nephrosclerosis, is a close commensurate of blood pressure, it can be predicted that ...

The highest prevalence of hypertension is now recognized to exist in the elderly segment of the population. With the completion of several large-scale studies, several of our assumptions regarding elderly hypertensive patients have changed. It is now clear that the elderly have shown the greatest benefit from antihypertensive therapy. This ...

A meta-analysis is presented of 8 therapeutic trials in elderly hypertensive patients. In an intention-to-treat analysis, cardiovascular mortality was decreased on average by 22% (95% confidence interval ranging from -32% to -10%). This decrease was explained by both a reduction in coronary mortality by 26% (-40% to -9%) and in ...

Hypertension is increasingly common with advancing age and a risk factor for all kinds of cardiovascular complications. Moreover, cardiovascular disease is a major cause of morbidity and mortality in the elderly. The Swedish Trial in Old Patients with Hypertension (STOP-Hypertension) was set up by the Swedish Hypertension Society to investigate ...

Several studies have demonstrated an increased risk of cardiovascular disease (CVD) in relation to high blood pressure in elderly patients aged below 70-75, whereas the risk seemed to decline with age in the older elderly. Early studies on the effect of treatment of mild to moderate hypertension in the elderly ...

Syncope is a common and highly morbid syndrome with unique features in the elderly population. Syncope in the elderly is more likely due to the accumulation of multiple pathological conditions which threaten cerebral oxygen delivery, then to single diseases. Furthermore, age-related changes in blood pressure homeostasis make older patients more ...

The psychomotor and cardiovascular effects of minaprine 100 mg, a novel antidepressant, were compared with amitriptyline 25 mg, as a positive control, and placebo in a single dose randomised double-blind crossover trial using an automated psychomotor test battery (APT), postural sway (PS), blood pressure (BP) and pulse in nine young ...

Acute changes in blood pressure and heart rate during cigarette smoking were investigated in 10 elderly subjects aged 75.6 +/- 4.8 (mean +/- SD) years and in 10 non-elderly subjects aged 35.6 +/- 10.5 years. All subjects were healthy normotensive men with no cardiovascular disease. While each subject smoked two ...

Interest in isolated systolic hypertension in the elderly has increased in the last few years. The definition of this disorder remains controversial: according to most authors, the systolic blood pressure has to be above 160 mm Hg and the diastolic under 90 mm Hg. The prevalence depends on number of ...

Hypertension is a major complication in kidney transplantation and contributes to the high cardiovascular mortality of renal transplanted recipients. The aim of the present study was to evaluate the therapeutic effect of phlebotomy on blood pressure in posttransplant hypertension associated with erythrocytosis. In 12 renal transplanted patients (7 male, 5 ...

The authors examined whether changing attitudes and approaches to modifying blood pressure during the 1980s affected the previously described pattern of increasing systolic blood pressure in the elderly which continues through the ninth decade of life. In 1982-1983, a door-to-door census identified 4,497 community-dwelling residents of East Boston, Massachusetts aged ...

Fourteen hypertensive patients hospitalized in a paediatric intensive care unit were studied to evaluate safety and hypotensive efficacy of intravenous nicardipine. Systolic and diastolic blood pressure significantly decreased 1 h after the beginning of the treatment (1 microgram/kg per minute). Mean decrease in systolic blood pressure during the first 24 ...

Effective treatment of hypertension in the elderly requires an understanding of both the progressive course of the disease and the impact of aging on the cardiovascular system, including physiological, genetic, lifestyle, and environmental factors. Review of the literature that has attempted to define the impact of an "aging process" on ...

Long-term follow-up evaluation of biofiltration treatment in 7 patients is presented. These patients experienced frequent episodes of hypotension during acetate hemodialysis. A 3-year biofiltration treatment reduced by 43% episodes of symptomatic hypotension and produced a significant increase in the pretreatment pH and plasma bicarbonate levels. The beta 2-microglobulin level was ...

BACKGROUND: National Health Care Issues-II deals with two reports of tremendous importance to national health, the results of the Systolic Hypertension in the Elderly Program (SHEP) and the results of the Trials of Hypertension Prevention, Phase I (TOHP-I). Both of these issues have tremendous impact on the systemic and ocular ...

A study was performed to evaluate histamine release, as well as potential cardiovascular and cutaneous sequelae, following bolus administration of atracurium in elderly patients. In 15 patients, using a radioenzymatic technique, plasma histamine concentrations were measured in venous blood samples obtained before and after induction of anaesthesia with thiopentone and ...

In elderly patients, elevation of systolic blood pressure represents a more serious risk than elevation of diastolic blood pressure. Major trials of antihypertensive therapy in the elderly include the Systolic Hypertension in the Elderly Program, the Swedish Trial of Older Patients with Hypertension, the Medical Research Council Trial, and the ...

Hypertension is common in elderly subjects, but old and particularly very old people have usually been excluded from major epidemiological trials. We studied 179 hypertensive subjects aged 80 years or more drawn from elderly people of an Italian town within the context of the CASTEL (Cardiovascular Study in the Elderly). ...

We investigated the effect of membrane bio-incompatibility on cardiovascular stability in 10 patients with combined acute hepatic and renal failure during 44 isovolemic intermittent machine hemofiltration treatments, using a polyamide membrane in 24 and a polyacrylonitrile membrane in 20. Cardiac output decreased by 14 +/- 2% during polyamide treatment compared ...

1. Whether non-steroidal anti-inflammatory drug (NSAID) usage in the elderly elevates blood pressure or antagonises the blood pressure-lowering effect of antihypertensive medication is presently unknown. The primary aims of this study were to estimate the prevalence of NSAID usage, to evaluate the prescription of NSAIDs for arthritis and to determine ...

Hypertension and its cardiovascular consequences are growing medical problems in the elderly. Hypertension in older patients is characterized not only by an increase in peripheral vascular resistance, but also by a reduction in arterial compliance. These abnormalities result in marked rises in systolic pressures and variable diastolic pressures that range ...

Pseudohypertension has often been reported in elderly subjects, but is an unusual phenomenon in children. We report the case of a 5-year-old child who presented with features of Williams syndrome (characterized by elfin facies, supravalvar aortic stenosis, and peripheral pulmonary artery stenosis). Repeated blood pressure recordings made with appropriately sized ...

Several imperatives drive the need to establish the merit of treating isolated systolic hypertension in the elderly. These include its higher prevalence with age, the associated excess cardiovascular risks, and the rapid aging of the population. The Systolic Hypertension in the Elderly Program demonstrated a significant reduction in stroke incidence ...

Importance of systolic over diastolic blood pressure measurements: Systolic pressure is known to be a more important independent cardiovascular risk factor than diastolic pressure in subjects over 50 years of age; after that age, a high incidence of two types of systolic hypertension is observed, sustained essential hypertension with a ...

A cross-sectional epidemiologic survey was undertaken in slums in the catchment areas of two health centers in Bangkok. Two hundred and sixty representative households were randomly selected. All adults (993) aged 20 years and over who lived in the households were asked to participate. The results were, however, based on ...

1. The cardiovascular responses to high-fat and high-carbohydrate meals (2.5 MJ) were compared in healthy, non-obese elderly subjects (mean age 68 years, range 63-74 years). 2. Measurements of cardiac output, blood pressure, heart rate, calf blood flow and superior mesenteric artery blood flow were made before and for 60 min ...

Simultaneous noninvasive blood pressure measurement were recorded bilaterally in 40 young and 40 elderly subjects. Overall interarm blood pressure (BP) differences for the elderly and young groups were similar, the absolute interarm differences being for systolic blood pressure (SBP) elderly: 4.2 mmHg (95% CI 3.1-5.3 mmHg); young 3.3 mmHg(2.6-4.1 mmHg); ...

Treatment of hypertension in the elderly has hitherto been considered to be potentially dangerous. Three recent studies have clearly shown that in selected elderly hypertensives, blood pressure reduction very effectively reduces cardiovascular complications without causing unacceptable adverse effects. The impact on non-fatal stroke was most striking although a reduction in ...

While structural and functional signs of a genetic predisposition to hypertension may sometimes be detected in the juvenile cardiovascular system, the borderline phase characteristic of young hypertensive patients is often dominated by a 'hyperkinetic' circulatory state. The modest pressure elevation is then mainly due to an increase in cardiac output ...

The prevalence of hypertension increases with age. Multiple physiologic factors are involved in the development of hypertension in the elderly. Alpha1-adrenergic blocking agents lower blood pressure through a reduction in total peripheral resistance. Prazosin, terazosin, and doxazosin have been shown to be equally effective in reducing blood pressure in older ...

To examine the effects of calcium and vitamin D supplementation on blood pressure and calcium metabolism, we conducted a randomized, double-blind, 2 x 2 factorial intervention study in 58 institutionalized elderly persons. The subjects were randomly allocated into four groups to receive: (1) calcium (800 mg/day) + vitamin D3 placebo, ...

In attempting to clarify the effects of aging on the regulatory functions of the cardiovascular system, we measured blood pressure, heart rate and stroke volume during thermoneutral head-out water immersion in seven healthy elderly and eight healthy young subjects. In the young subjects water immersion resulted in a marked increase ...

OBJECTIVE: Adherence to treatment is a key factor in achieving blood pressure control among hypertensives. We examined correlates of nonadherence to hypertension treatment in an inner-city minority population. METHODS: Subjects (n = 202) were interviewed as part of a case-control study of severe, uncontrolled hypertension conducted in two New York ...