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High Blood Pressure Management Declines With Age:
New Study
July 27, 2005 - Nearly three-quarters of men and
women age 80 and older have high blood pressure, but their conditions
are frequently not kept under control, according to new data from the
National Heart, Lung, and Blood Institute’s (NHLBI) long-standing
Framingham Heart Study. In this age group, only 38 percent of men and 23
percent of women had blood pressures that met targets set forth in the
National High Blood Pressure Education Program’s (NHBPEP) clinical
guidelines.
Full study results are published in the today’s
edition of the Journal of the American Medical Association.
This study shows that while the rate of high blood
pressure increased with age, numbers of people receiving treatment for
the condition did not. Seventy-four percent of people age 80 and older
had high blood pressure, compared with 63 percent of those age 60 to 79
and 27 percent of those under the age of 60. However, less than two
thirds of hypertensive patients in the two older age groups received
treatment.
High blood pressure, also called hypertension, is a
major risk factor for the development of heart disease and a leading
cause of many life-threatening conditions such as stroke, heart attack,
and kidney failure.
“Many more men and women are now living healthy and
active lives into their 80s and 90s. As clinicians, we should not loosen
our management of high blood pressure just because a patient has had the
good fortune to reach an older age,” said Daniel Levy, M.D., director of
the Framingham Heart Study and a study co-author. “For these patients,
managing high blood pressure may make the difference between living many
more healthy years, or spending those years recovering from a
debilitating stroke or heart attack.”
Investigators from the Framingham Heart Study, a
landmark epidemiological study that began in 1948, analyzed data from
its original cohort of participants, enrolled in 1948-1952, and their
offspring, enrolled 1971-1973. In all, this study included 5,296
participants contributing 14,458 total examinations over the period
studied. High blood pressure was defined as a systolic blood pressure of
greater or equal to 140 mm Hg or diastolic blood pressure greater than
or equal to 90 mm Hg, or taking medication for reducing blood pressure.
Normal blood pressure is less than 120 mm Hg systolic and less than 80
mm Hg diastolic.
According to the authors, the data suggest that the poor control rates
may be due in part to poor selection of drug classes or from the use of
a single drug for therapy. Among all ages studied, 60 percent of
patients were treated with only one antihypertensive medication, and
only 23 percent of men and 38 percent of women over age 80 were being
treated with a diuretic.
Guidelines issued by NHLBI’s NHBPEP state that most
high blood pressure patients will require two or more medications to get
blood pressure down to target levels, and that a diuretic should be one
of the medications used. Diuretics have been shown to be more beneficial
in lowering blood pressure and protecting against adverse complications
of hypertension.
The NHLBI’s hypertension guidelines are available
online in the Seventh Report of the Joint National Committee on the
Prevention, Detection, Evaluation and Treatment of High Blood Pressure.
The guidelines are available online at
http://www.nhlbi.nih.gov/guidelines/hypertension/index.htm.
To arrange an interview with Dr. Levy, please call
the NHLBI Communications Office at (301) 496-4236. To interview the
study’s lead author, Dr. Donald M. Lloyd-Jones of Northwestern
University’s Feinberg School of Medicine, please call (312) 503-8928.
NHLBI is part of the National Institutes of Health
(NIH), the Federal Government’s primary agency for biomedical and
behavioral research. NIH is a component of the U.S. Department of Health
and Human Services.
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