Epidemiology of hypertension in older patients.

There are few studies devoted specifically to the epidemiology of older hypertensive patients, although some information has been obtained from broader trials in which either the study populations have become older or an older subgroup has been identified. Three areas have been addressed: the changes of blood pressure with age; the prevalence of hypertension in older persons; and the risks of elevated blood pressure in elderly patients. It has been found that blood pressure, especially systolic pressure, increases with age. Consequently, hypertension is extremely prevalent in this age group, affecting 65 percent or more of those over 65 years old, and the phenomenon of isolated systolic hypertension is common. Whereas in the past many physicians treating the elderly have regarded hypertension in these patients as normal and acceptable, or even helpful in ensuring adequate organ perfusion, elevated blood pressure in the elderly is far from benign. Older hypertensive patients' risks of cardiovascular complications and death are from two to five times that of normotensive persons. Treatment of diastolic hypertension in older patients can be expected to delay the onset of cardiovascular disease and improve the quality of life. Hopefully, this will prove to be true for isolated systolic hypertension as well.