Hypertension – Epidemiology

 

 

 

damage_hypertension

 

 

Hypertension, a common problem in elderly (age > 60 to 65), reaches a prevalence as high as 60 to 80 percent. In the National Health and Nutrition Examination Survey (NHANES) of USA hypertension was observed in 67 percent of adults aged 60 years and older participants.

Hypertension   clickhere_red25    高血壓      clickhere_orange25

National Health and Nutrition Examination Survey   clickhere_green25

 

 

screenshot_bp_for_adultSystolic hypertension   clickhere_red25

 

Two reports in respect of the risk of developing hypertension over time in an elderly person, who is normotensive 血壓正常, have been presented by Framingham Heart Study

Framingham Heart Study   clickhere_orange25

 


Study on the incidence of hypertension defined with;
– Blood pressure > 140/90 mmHg (SYS/DIA)
OR
– Need to taking antihypertensive drug

Period of study – 4 years
Finding:
Among individuals initially with optimal (less than 120/80 mmHg), normal (120 to 129/80 to 84 mmHg), or high-normal (130 to 139/85 to 89 mmHg) blood pressure.
– A progressive increase found in the frequency of development of hypertension in patients over age 65 years (16, 26, and 50 percent in the optimal, normal, and high-normal groups, respectively).
– Similar findings also found in younger individuals, but the rates of progression were lower.

 


Individuals aged 55 to 65 years without hypertension have:
– 90 percent lifetime risk developing stage 1 hypertension (blood pressure 140 to 159/90 to 99 mmHg SYS/DIA)
– 40 percent lifetime risk of developing stage 2 hypertension (blood pressure ≥160/≥100 mmHg SYS/DIA).

 


When the systolic blood pressure exceeds 160 in elderly aged 60 and above, treatment consideration is necessary even if the diastolic blood pressure is normal, less than 90.

Systolic blood pressure is considered high when it’s 140 or above. When the number of Diastolic blood pressure is less than 90, treatment is generally considered only when systolic blood pressure tops 160. Among older patients, the evidence isn’t yet clear that the pros outweigh the cons of treating it in 140-160 range.

High systolic blood pressure in elderly 60 and over is a much more important heart disease risk factor than high diastolic blood pressure.

 


A blood pressure of 140/90 mmHg or higher for an elderly is considered high blood pressure. Both numbers are important. If one or them are usually high, the elderly has high blood pressure.

If an elderly under treatment on high blood pressure with repeated readings in the normal range, he/she has high blood pressure.