ELDERLY AND HYPERTENSION
A new study just released at a major medical conference shows that the population at highest risk from high blood pressure is the least likely to be appropriately treated.
Hypertension in the elderly is a silent but deadly killer. And as we get older, we are more prone to it, and to the complications of hypertension, including heart attack and stroke.
But because older patients are considered fragile, doctors tend to be timid in prescribing the appropriate treatment for hypertension in the elderly.
“It’s a very well tolerated medication,” Arthur Ginsberg’s physician Dr. Marc Siegel advises his patient. On this day, Arthur, at the age of 80, got a new medicine for a newly diagnosed condition--high blood pressure.
“I was certain that when they took my blood pressure that it was going to be normal because I felt so good. I didn’t feel edgy upset or nervous at all,” Arthur said.
Dr. Siegel is less amazed at the new diagnosis. “It’s not surprising that hypertension in the elderly is common. It usually occurs because of the hardening of the arteries which is the cause of high blood pressure.”
New research presented at the American Society of Hypertension’s annual scientific meeting identifies a huge problem of under treated hypertension in the elderly. Nearly three-quarters of people over the age of 80 have high blood pressure. Yet one third of them don’t get treated. They may be getting some medication, but clearly, not enough. “I think that doctors tend to be reluctant to give medications to bring blood pressure down to the right range,” Dr. Siegel believes. “I think we are concerned about side effects of medication given to treat hypertension in the elderly, because they do tend to exhibit more side effects. So the recommendation that the study data comes with, that we ought to go slowly but increase the medication to proper ranges, is very appropriate.”
It could take several weeks to get the blood pressure under control. And to treat hypertension in the elderly it often takes more than one medication. So patience is often needed in treating high blood pressure in the elderly. Dr. Siegel believes it should be checked more frequently than just once a year. He says once a quarter would be more appropriate in individuals over the age of 80.
Hypertension in the elderly comes with a number of complications associated with high blood pressure, among them increased risk of heart attack, stroke, and kidney failure. This is why preventing these complications with enough medication to get the blood pressure under control is important for treating hypertension in elderly patients like Arthur. “I would not like to live beyond 92 but I would not like to live less than that,” admits Arthur. He is actually worried, because he’s getting appropriately treated, that he might live beyond the age his life insurance policies expire.
But he jokes, “I gotta find a hit man that’s going to take me out!”
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