Treatment Gap Exists Between Middle-Aged and Older-Aged Hypertensives

Isolated systolic hypertension is the majority subtype of uncontrolled hypertension in people in their 50s and comprises 87 percent frequency for patients in the sixth decade of life.

This is contrary to previous perceptions.

Furthermore, greater reduction in systolic blood pressure in these patients versus younger people is required to meet treatment goals.

Increased awareness of this middle-aged and older high-risk group and also more aggressive antihypertensive therapy are both needed to deal with the gap in treatment, these authors conclude.

Researchers from the Heart Disease Prevention Program, University of California, Irvine, California, and Bristol-Myers Squibb, Pharmaceutical Research Institute, Princeton, New Jersey, United States, did this study.

Study objective was to examine patterns of systolic and diastolic hypertension by age in the nationally representative US National Health and Nutrition Examination Survey (NHANES) III and to determine when treatment and control efforts should be recommended.

Researchers categorized percentage distribution of three blood pressure subtypes for uncontrolled hypertension-both untreated and inadequately treated-in two age groups.

Blood pressure subtypes were isolated systolic hypertension, combined systolic/diastolic hypertension and isolated diastolic hypertension.

The two age groups studied were those less than 50 years and those 50 years and older.

Overall, isolated systolic hypertension was the most frequent subtype of uncontrolled hypertension (65 percent).

Most subjects with hypertension-74 percent-were 50 years of age. Of this untreated older group, nearly all (94 percent) were accurately staged by systolic blood pressure alone.

This was in contrast with those in the untreated younger group, who were best staged by diastolic blood pressure.
Furthermore, most subjects (80 percent) in the older untreated and inadequately treated groups had isolated systolic hypertension and required a greater reduction in systolic blood pressure to attain a systolic blood pressure treatment goal of <140 mm Hg than did those in the younger groups. Hypertension. 2001;37:869.