NHLBI Study: High Blood Pressure
Not Well Controlled Among Older Men and Women
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 will be published in the July 27,
2005, 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.
NHLBI press releases and fact sheets, including information
on high blood pressure, can be found online at www.nhlbi.nih.gov
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