Dr. Roccella: How about managing hypertension in older women, or even men for that matter. I mean, why bother? Is there any evidence that managing blood pressure in, say, somebody at 75 or 80 will matter?
Dr. Black: We can now say yes. We couldn't have a couple of months or maybe a year or so ago, with the exception of those who had a high systolic as the upper number and a lower diastolic as the lower number. But we now have a trial called HYVET which looked at healthy 80-year-olds and treated them for about two years with a combination of a diuretic and an ACE inhibitor and compared the results to those who got a placebo. Those on active medicines had a dramatic drop in stroke and heart failure and even mortality with very little, if any, side effects of adverse consequences. So there is no longer any justification for ignoring an elevated blood pressure, regardless of someone's age.
Dr. Roccella: You said earlier that if you reach age 55, you have a 90 percent chance that you are going to have hypertension in your lifetime. Are you telling us that we are all going to be hypertensive?
Ms. Houston Miller: At least one in three of us will. I think that if we focused on lifestyle changes much earlier, then we could probably prevent a large part of not only the development of cardiovascular disease but also these other target organ problems that occur as a result of high blood pressure.
Dr. Black: We don't want to scare people, because the alternative to not getting to 85 or 95 is worse than getting there. We just have to be aware that this is going to be a problem as we age, and we have to be prepared to deal with it and it need not be difficult to deal with. We now know that people over the age of 80 -- and probably without any age limit -- can have their blood pressure and the risk of blood pressure complications reduced. That is good news.
Click these links to read more from Sister to Sister’s Expert Roundtable on High Blood Pressure:
Introduction
Blood Pressure Basics
Symptoms & Screening
Treatment Benefits
Treatment Options
Drug Side Effects
Drug Interactions
Medication Costs
Prehypertension
Aging's Impact
High-Risk Groups
Future Goals