Arterial hypertension in the elderly. Experience at a hospital service.

L Carvalho, F Gonçalves, J G Clara


High blood pressure in the elderly population is currently one of the most important public health problems. In recent years, a dramatic increase in life expectancy has occurred and cardiovascular diseases are now one of the major causes of morbidity and mortality in this age group. Therefore, high blood pressure in the elderly has been the aim of many trials throughout the world. In Medicine Department 1 of St. Maria Hospital, we designed and implemented a special outpatient follow-up for elderly people (> or = 65 years old) with hypertensive disease. At the end of the first year, 61 patients (22 men and 39 women) with an average age of 71 years (SD +/- 5.3), with known of high blood pressure for an average of 10 years were treated with angiotensin converting enzyme inhibitor (11 patients), calcium channel blockers (6 patients), or a combination of both drugs. The mean blood pressure fell 15 mm Hg (SD +/- 19.6) without deterioration of the renal function. The echocardiographic evaluation showed reduction in the left ventricular dimensions without significant modifications of diastolic, systolic and cardiac output. In addition, there was a significant increase in attention/concentration and memory abilities, however the percentage of depressed patients was the same at the end of the first year of treatment for high blood pressure.

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