Controlling Blood Pressure in Older Patients

Among men and women age 80 and older, only 38% of men and 23% of women have blood pressures that meet targets set by U.S. guidelines, according to new data from the Framingham Heart Study of the U.S. National Heart, Lung, and Blood Institute (NHLBI, Bethesda, MD, USA). The findings were reported in the July 27, 2005, issue of the Journal of the American Medical Association.

Although the study showed that the rate of high blood pressure increased with age, the numbers of people receiving treatment for the condition did not. For example, 74% of people 80 and over had high blood pressure, compared with 63% of those aged 60-70 and 27% of those under 60. However, less than two-thirds of hypertensive patients in the two older groups received treatment.

"Many more men and women are now living healthy and active lives into their 80s and 90s,” said co-author Daniel Levy, M.D., director of the Framingham Heart Study. "For these patients, managing high blood pressure may make the difference between living more healthy years or spending those years recovering from a debilitating stroke or heart attack.”

The study's authors note that the data suggest poor control rates may be due in part to poor selection of drug classes or to the use of a single drug for therapy. Among all ages studied, 60% were treated with only one antihypertensive drug and only 23% of men and 38% of women over age 80 were treated with a diuretic. According to U.S. guidelines, most blood-pressure patients require two or more medications to get blood pressure down to target levels, and a diuretic should be one of the medications used.