Clinical Feature and Treatment of Hypertension in Patients 75 Years or Older
1Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine, Department of Internal Medicine, Graduate School of Medicine, Nippon Medical School
2Department of Internal Medicine (Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine), Nippon Medical School
People 65 years and older can be divided into 2 groups: the young old (those aged 65 to 74 years) and the old old (those 75 years or older). The old old are at greater risk for several common geriatric syndromes, such as depression, cognitive impairment, urinary incontinence, injurious falls, and persistent pain. Comprehensive geriatric assessment programs linking geriatric evaluation with strong long-term management are effective for improving survival and function in older persons. Diastolic blood pressure decreases after 60 years in association with a continual rise in systolic blood pressure. Whether treatment of hypertension for patients 80 years or older is beneficial is still unclear. Epidemiologic population studies have suggested that blood pressure and the risk of death are negatively correlated in people 80 years or older. The Hypertension in the Very Elderly Trial, suggests that antihypertensive treatment in persons 80 years or older is beneficial.
日医大医会誌 2009; 5(4), 207-210
old old, comprehensive geriatric assessment, treatment of hypertension
Hiroshi Nakano, Department of Internal Medicine (Division of Cardiology, Hepatology, Geriatrics, and Integrated Medicine), Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku Tokyo 113-8603, Japan