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Blood pressure and ageing

Correspondence to:
Correspondence to:
E Pinto
Faculty of Medicine, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK; e.pinto{at}imperial.ac.uk

ABSTRACT
Isolated systolic hypertension, an elevation in systolic but not diastolic pressure, is the most prevalent type of hypertension in those aged 50 or over, occurring either de novo or as a development after a long period of systolic-diastolic hypertension with or without treatment. The increase in blood pressure with age is mostly associated with structural changes in the arteries and especially with large artery stiffness. It is known from various studies that rising blood pressure is associated with increased cardiovascular risk. In the elderly, the most powerful predictor of risk is increased pulse pressure due to decreased diastolic and increased systolic blood pressure. All evidence indicates that treating the elderly hypertensive patient will reduce the risk of cardiovascular events. However, there is no evidence yet for the very elderly. This population is particularly susceptible to side effects of treatments and the reduction of blood pressure, although reducing the risk of cardiovascular events such as stroke, may result in increased mortality.

Abbreviations: BP, blood pressure; CHD, coronary heart disease; DBP, diastolic blood pressure; ISH, isolated systolic hypertension; LAS, large artery stiffness; NHANES III, the third National Health and Nutrition Examination Survey; OH, orthostatic hypotension; PP, pulse pressure; PPH, postprandial hypotension; PVR, peripheral vascular resistance; SBP, systolic blood pressure

Keywords: ageing; blood pressure; hypertension

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