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Hypertension in the Elderly
Can We Improve Results of Therapy?
L. Michael Prisant, MD;
Marvin Moser, MD
Arch Intern Med. 2000;160:283-289.
Awareness of and therapy for hypertension in the United States have been increasing in older patients. Despite this improvement, hypertension continues to be poorly controlled in this patient population. The control rate, defined as systolic blood pressure less than 140 mm Hg and diastolic blood pressure less than 90 mm Hg, is surprisingly low for older patients, despite abundant data documenting the reduction of cardiovascular events by treating both systolic-diastolic and isolated systolic hypertension. Comorbid diseases and physiological alterations in the elderly, including reduced myocardial contractility, renal function, total body water, baroreceptor responsiveness, and cognitive function, must be considered, but in general these have not limited the effectiveness of antihypertensive drug therapy.
From the Section of Cardiology, Hypertension Unit, Medical College of Georgia, Augusta (Dr Prisant); and the Department of Medicine, Yale University School of Medicine, New Haven, Conn (Dr Moser).
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