|NHLBI Study: High Blood Pressure
Not Well Controlled Among Older Men and Women
Nearly three-fourths of men and women age 80 and older
have high blood pressure, but their conditions are frequently
not kept under control, according to new data from the
National Heart, Lung, and Blood Institute’s (NHLBI)
long-standing Framingham Heart Study. In this age group,
only 38 percent of men and 23 percent of women had blood
pressures that met targets set forth in the National
High Blood Pressure Education Program’s (NHBPEP) clinical
Full study results will be published in the July 27,
2005, edition of the Journal of the American Medical
This study shows that while the rate of high blood
pressure increased with age, numbers of people receiving
treatment for the condition did not. Seventy-four percent
of people age 80 and older had high blood pressure,
compared with 63 percent of those age 60 to 79 and 27
percent of those under the age of 60. However, less
than two thirds of hypertensive patients in the two
older age groups received treatment.
High blood pressure, also called hypertension, is a
major risk factor for the development of heart disease
and a leading cause of many life-threatening conditions
such as stroke, heart attack, and kidney failure.
“Many more men and women are now living healthy and
active lives into their 80s and 90s. As clinicians,
we should not loosen our management of high blood pressure
just because a patient has had the good fortune to reach
an older age,” said Daniel Levy, M.D., director of the
Framingham Heart Study and a study co-author. “For these
patients, managing high blood pressure may make the
difference between living many more healthy years, or
spending those years recovering from a debilitating
stroke or heart attack.”
Investigators from the Framingham Heart Study, a landmark
epidemiological study that began in 1948, analyzed data
from its original cohort of participants, enrolled in
1948-1952, and their offspring, enrolled 1971-1973.
In all, this study included 5,296 participants contributing
14,458 total examinations over the period studied. High
blood pressure was defined as a systolic blood pressure
of greater or equal to 140 mm Hg or diastolic blood
pressure greater than or equal to 90 mm Hg, or taking
medication for reducing blood pressure. Normal blood
pressure is less than 120 mm Hg systolic and less than
80 mm Hg diastolic.
According to the authors, the data suggest that the
poor control rates may be due in part to poor selection
of drug classes or from the use of a single drug for
therapy. Among all ages studied, 60 percent of patients
were treated with only one antihypertensive medication,
and only 23 percent of men and 38 percent of women over
age 80 were being treated with a diuretic.
Guidelines issued by NHLBI’s NHBPEP state that most
high blood pressure patients will require two or more
medications to get blood pressure down to target levels,
and that a diuretic should be one of the medications
used. Diuretics have been shown to be more beneficial
in lowering blood pressure and protecting against adverse
complications of hypertension.
The NHLBI’s hypertension guidelines are available online
in the Seventh Report of the Joint National Committee
on the Prevention, Detection, Evaluation and Treatment
of High Blood Pressure. The guidelines are available
online at http://www.nhlbi.nih.gov/guidelines/hypertension/index.htm
To arrange an interview with Dr. Levy, please call
the NHLBI Communications Office at (301) 496-4236. To
interview the study’s lead author, Dr. Donald M. Lloyd-Jones
of Northwestern University’s Feinberg School of Medicine,
please call (312) 503-8928.
NHLBI is part of the National Institutes of Health
(NIH), the Federal Government’s primary agency for biomedical
and behavioral research. NIH is a component of the U.S.
Department of Health and Human Services. NHLBI press
releases and fact sheets, including information on high
blood pressure, can be found online at www.nhlbi.nih.gov.
The National Institutes of Health (NIH) — The
Nation's Medical Research Agency — is comprised
of 27 Institutes and Centers and is a component of
the U. S. Department of Health and Human Services.
It is the primary Federal agency for conducting and
supporting basic, clinical, and translational medical
research, and investigates the causes, treatments,
and cures for both common and rare diseases. For more
information about NIH and its programs, visit www.nih.gov.