Abstract P373: A Cohort Study in Elderly Population - Differences Between Older and Very Older Subjects

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2017-09, Vol.70 (suppl_1)
• Main Authors: Rodrigues, Livia F, Lopes, Patricia d, Prado, Yasmin S, dos Santos, Mariella P, Lucci, Maria A, Rocha, Ligia d, Almeida, Paulo E, Costa, Lílian S
• Format: Article
• Language: English
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/hyp.70.suppl_1.p373

Abstract only Introduction: It is known that isolated systolic hypertension (ISH) and elevated pulse pressure (PP) play an important role in the development of cerebrovascular disease, congestive heart failure, and coronary heart disease, which are the major causes of cardiovascular morbidity and mortality in the population aged older than 65 years. The systolic blood pressure (BP) has been proven to be a stronger predictor of cardiovascular diseases than diastolic BP and a correlation between mortality and high BP has been extensively proven for those in late life until around the age of 80 years. Objective: To evaluate BP profile on 24-hour, daytime and night time periods, pulse pressure (PP), riser BP pattern and systolic and diastolic nocturnal drop in an elderly population, referred to be clinically healthy with no prior history of CV disease and off CV medications. Methods: We analyzed a cohort of 1300 elderly patients aged over 65 years and compared the ambulatory blood pressure data of elderly individuals (G1) aged 65-79 years (1020 subjects, mean 67.16 years, 64.7% female) and very elderly individuals (G2) aged over 80 years (280subjects, mean 83.89 years, 69.3% female). Results: Differing trends for systolic and diastolic BP between groups resulted in large differences in ambulatory PP, it being significantly greater ( p = 0.001) throughout the entire 24-hour in G2, even after correcting for age (24-hour, daytime and night time periods being 55,07 x 66,76mmHg, 55,31 x 67,03mmHg and 54,55 x 65,95mmHg , respectively in G1 and G2). The prevalence of non-dipping was not significantly higher in G2. Largest difference between groups was in the prevalence of the riser BP pattern, asleep systolic BP mean greater than awake SBP mean (18,7% vs. 6,5% in patients G2 and G1, respectively; p 0.001). Conclusions: There is a growing recognition of the importance of the systolic component of BP. About 65% of hypertension in the elderly is ISH, and CVD risk increases with PP, which is not simply a marker for stiff diseased arteries; elevated PP and asleep systolic BP mean was the major basis for the diagnosis and stratification of ISH.