Skip to main content
NCBI home page
The Journal of the Royal College of General Practitioners logoLink to The Journal of the Royal College of General Practitioners
. 1976 Oct;26(171):745–749.

Blood pressure in the elderly

John Coope
PMCID: PMC2158286  PMID: 794464

Abstract

The distribution of blood pressure levels in elderly patients is described and the evidence that higher levels are associated with morbidity at this age is reviewed. In the absence of definitive evidence about the results of treating hypertension in the elderly, the physiological factors that have to be taken into account are surveyed with particular reference to aggravating cerebral ischaemia.

More potent hypotensive agents should be avoided in older patients and in practice the decision on whether to treat may depend more on the clinical context than on the level of the blood pressure itself.

Full text

PDF
745

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADAMS G. F., MERRETT J. D. Prognosis and survival in the aftermath of hemiplegia. Br Med J. 1961 Feb 4;1(5222):309–314. doi: 10.1136/bmj.1.5222.309. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. ANDERSON W. F., COWAN N. R. Arterial pressure in healthy older people. Clin Sci. 1959 Feb;18(1):103–117. [PubMed] [Google Scholar]
  3. Amery A., De Schaepdrijver A. Letter: Should elderly hypertensives be treated? Lancet. 1975 Feb 1;1(7901):272–273. doi: 10.1016/s0140-6736(75)91166-6. [DOI] [PubMed] [Google Scholar]
  4. BROWN M. L., RODSTEIN M., ZEMAN F. D. The relationship of changes of blood and pulse pressure to cardiovascular status in 100 aged individuals. Am J Med Sci. 1963 Jun;245:676–681. [PubMed] [Google Scholar]
  5. Bauer G. E. Treatment of hypertension in the elderly. Drugs. 1974;7(3):310–318. doi: 10.2165/00003495-197407030-00005. [DOI] [PubMed] [Google Scholar]
  6. Beevers D. G., Fairman M. J., Hamilton M., Harpur J. E. Antihypertensive treatment and the course of established cerebral vascular disease. Lancet. 1973 Jun 23;1(7817):1407–1409. doi: 10.1016/s0140-6736(73)91737-6. [DOI] [PubMed] [Google Scholar]
  7. Carter A. B. Hypotensive therapy in stroke survivors. Lancet. 1970 Mar 7;1(7645):485–489. doi: 10.1016/s0140-6736(70)91577-1. [DOI] [PubMed] [Google Scholar]
  8. Chapman J. M., Coulson A. H., Clark V. A., Borun E. R. The differential effect of serum cholesterol, blood pressure and weight on the incidence of myocardial infarction and angina pectoris. J Chronic Dis. 1971 Feb;23(9):631–645. doi: 10.1016/0021-9681(71)90159-7. [DOI] [PubMed] [Google Scholar]
  9. Colandrea M. A., Friedman G. D., Nichaman M. Z., Lynd C. N. Systolic hypertension in the elderly. An epidemiologic assessment. Circulation. 1970 Feb;41(2):239–245. doi: 10.1161/01.cir.41.2.239. [DOI] [PubMed] [Google Scholar]
  10. Corman L. A., Skversky N. J. Methyldopa-hydrochlorothiazide therapy in hypertensive geriatric patients. J Am Geriatr Soc. 1973 Jan;21(1):36–39. doi: 10.1111/j.1532-5415.1973.tb00848.x. [DOI] [PubMed] [Google Scholar]
  11. Cutler J. L. Cerebrovascular disease in an elderly population. Circulation. 1967 Sep;36(3):394–399. doi: 10.1161/01.cir.36.3.394. [DOI] [PubMed] [Google Scholar]
  12. DROLLER H., PEMBERTON J., ROSEMAN C., GROUT J. L. A. High blood pressure in the elderly. Br Med J. 1952 Nov 1;2(4791):968–970. doi: 10.1136/bmj.2.4791.968. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. EDWARDS F., McKEOWN T., WHITFIELD A. G. Arterial pressure in men over sixty. Clin Sci. 1959 May;18:289–300. [PubMed] [Google Scholar]
  14. EVANS P. H. RELATION OF LONGSTANDING BLOOD-PRESSURE LEVELS TO ATHEROSCLEROSIS. Lancet. 1965 Mar 6;1(7384):516–519. doi: 10.1016/s0140-6736(65)92022-2. [DOI] [PubMed] [Google Scholar]
  15. Eisalo A., Heino A., Munter J. The effect of alprenolol in elderly patients with raised blood pressure. Acta Med Scand Suppl. 1974;554:23–31. doi: 10.1111/j.0954-6820.1974.tb02510.x. [DOI] [PubMed] [Google Scholar]
  16. FAZEKAS J. F., BESSMAN A. N., COTSONAS N. J., Jr, ALMAN R. W. Cerebral hemodynamics in cerebral arteriosclerosis. J Gerontol. 1953 Apr;8(2):137–145. doi: 10.1093/geronj/8.2.137. [DOI] [PubMed] [Google Scholar]
  17. Fry J. Natural history of hypertension. A case for selective non-treatment. Lancet. 1974 Aug 24;2(7878):431–433. doi: 10.1016/s0140-6736(74)91816-9. [DOI] [PubMed] [Google Scholar]
  18. GUBNER R. S. Systolic hypertension: a pathogenetic entity. Significance and therapeutic considerations. Am J Cardiol. 1962 May;9:773–776. doi: 10.1016/0002-9149(62)90139-x. [DOI] [PubMed] [Google Scholar]
  19. HAMILTON M., PICKERING G. W., ROBERTS J. A. F., SOWRY G. S. The aetiology of essential hypertension. I. The arterial pressure in the general population. Clin Sci. 1954 Feb;13(1):11–35. [PubMed] [Google Scholar]
  20. HUGHES W., DODGSON M. C., MACLENNAN D. C. Chronic cerebral hypertensive disease. Lancet. 1954 Oct 16;267(6842):770–774. doi: 10.1016/s0140-6736(54)92498-8. [DOI] [PubMed] [Google Scholar]
  21. JOHNSON R. H., SMITH A. C., SPALDING J. M., WOLLNER L. EFFECT OF POSTURE ON BLOOD- PRESSURE IN ELDERLY PATIENTS. Lancet. 1965 Apr 3;1(7388):731–733. doi: 10.1016/s0140-6736(65)92090-8. [DOI] [PubMed] [Google Scholar]
  22. KENDELL R. E., MARSHALL J. Role of hypotension in the genesis of transient focal cerebral ischaemic attacks. Br Med J. 1963 Aug 10;2(5353):344–348. doi: 10.1136/bmj.2.5353.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Kannel W. B., Castelli W. P., McNamara P. M., McKee P. A., Feinleib M. Role of blood pressure in the development of congestive heart failure. The Framingham study. N Engl J Med. 1972 Oct 19;287(16):781–787. doi: 10.1056/NEJM197210192871601. [DOI] [PubMed] [Google Scholar]
  24. Kannel W. B., Gordon T., Schwartz M. J. Systolic versus diastolic blood pressure and risk of coronary heart disease. The Framingham study. Am J Cardiol. 1971 Apr;27(4):335–346. doi: 10.1016/0002-9149(71)90428-0. [DOI] [PubMed] [Google Scholar]
  25. Kannel W. B., Wolf P. A., Verter J., McNamara P. M. Epidemiologic assessment of the role of blood pressure in stroke. The Framingham study. JAMA. 1970 Oct 12;214(2):301–310. [PubMed] [Google Scholar]
  26. Kitchin A. H., Lowther C. P., Milne J. S. Prevalence of clinical and electrocardiographic evidence of ischaemic heart disease in the older population. Br Heart J. 1973 Sep;35(9):946–953. doi: 10.1136/hrt.35.9.946. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. MARSHALL J. A TRIAL OF LONG-TERM HYPOTENSIVE THERAPY IN CEREBROVASCULAR DISEASE. Lancet. 1964 Jan 4;1(7323):10–12. doi: 10.1016/s0140-6736(64)92157-9. [DOI] [PubMed] [Google Scholar]
  28. MASTER A. M., LASSER R. P., JAFFE H. L. Blood pressure in white people over 65 years of age. Ann Intern Med. 1958 Feb;48(2):284–299. doi: 10.7326/0003-4819-48-2-284. [DOI] [PubMed] [Google Scholar]
  29. Maddocks I., Vines A. P. The influence of chronic infection on blood-pressure in New Guinea males. Lancet. 1966 Jul 30;2(7457):262–264. doi: 10.1016/s0140-6736(66)92545-1. [DOI] [PubMed] [Google Scholar]
  30. Meyer J. S., Sawada T., Kitamura A., Toyoda M. Cerebral blood flow after control of hypertension in stroke. Neurology. 1968 Aug;18(8):772–781. doi: 10.1212/wnl.18.8.772. [DOI] [PubMed] [Google Scholar]
  31. Miall W. E., Chinn S. Screening for hypertension: some epidemiological observations. Br Med J. 1974 Sep 7;3(5931):595–600. doi: 10.1136/bmj.3.5931.595. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Neutra R. Letter: Treatment of hypertension. Lancet. 1974 Nov 2;2(7888):1089–1090. doi: 10.1016/s0140-6736(74)92202-8. [DOI] [PubMed] [Google Scholar]
  33. Prior I. A., Evans J. G., Harvey H. P., Davidson F., Lindsey M. Sodium intake and blood pressure in two Polynesian populations. N Engl J Med. 1968 Sep 5;279(10):515–520. doi: 10.1056/NEJM196809052791004. [DOI] [PubMed] [Google Scholar]
  34. Whitfield A. G. Iatrogenic misadventure. Br Med J. 1972 Mar 18;1(5802):733–734. doi: 10.1136/bmj.1.5802.733. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The Journal of the Royal College of General Practitioners are provided here courtesy of Royal College of General Practitioners

RESOURCES