How does hypertension (high blood pressure) progress in older adults?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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The classic trials for treatment of isolated systolic hypertension in the elderly are the Systolic Hypertension in the Elderly Program (SHEP) [103] and the Systolic Hypertension in Europe (Syst-EUR) [104] studies. Systolic pressure continues to rise progressively throughout life, reaching the highest levels in later stages of life. By the age of 60 years, of those with hypertension, about two thirds have isolated systolic hypertension, and by the age of 75 years, nearly all hypertensive patients have systolic hypertension, of which three quarters of cases are isolated hypertension. [5] Furthermore, severe arteriosclerosis may lead to pseudohypertension. Isolated hypertension results in low cardiac output because of the decreased stroke volume and high peripheral resistance. This may reduce glomerular filtration further, which is why low activity of renal angiotensin aldosterone cascade is encountered in elderly individuals who are hypertensive.

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