Skip to main content

Epidemiology of Hypertension in the Older Patient

  • Chapter
Hypertension in the Elderly

Abstract

Disease, disability, and death from cardiovascular disease (CVD) represent major problems in the elderly. As the elderly population continues to grow and constitute a larger proportion of the general population, the magnitude of the problem is expected to increase and to place a heavy burden on existing medical care resources. Heart disease and stroke continue to be the first and third leading causes of death in the United States, respectively. CVD becomes the leading cause of death by age 40 years, whereas in women this is delayed until age 70 years, accounting for the predominance of women in the elderly population (1).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. National Institutes of Health and National Heart, Lung, and Blood Institute. Chartbook on Cardiovascular, Lung and Blood Disease. Washington, DC: US Dept of Health and Human Services, Public Health Services.

    Google Scholar 

  2. Kannel WB, Abbott RD. Incidence and prognosis of unrecognized myocardial infarctions: An update from the Framingham Study. N Engl J Med 1984;34:1144–1147.

    Article  Google Scholar 

  3. Kannel WB, Wolf PA, Garrison RJ. The Framingham Study, Section 34: Some Risk Factors Related to the Incidence of Cardiovascular Disease and Death Using Pooled Repeated Biennial Measurements; Framingham Heart Study, 30-year Follow-up. Bethesda, MD: National Heart, Lung, and Blood Institute; 1987. NIH Publication 87-2703.

    Google Scholar 

  4. Kannel WB, D’Agostino RB. The importance of cardiovascular risk factors in the elderly. Am J Geriatr Cardiol 1995;2:10–23.

    Google Scholar 

  5. Centers for Disease Control and Prevention. National Center for Health Statistics Third National Health and Nutrition Examination Survey. 1988–1991.

    Google Scholar 

  6. Dannenberg AL, Garrison RJ, Kannel WB. Incidence of hypertension in the Framingham Study. Am J Public Health 1988;78:676–679.

    Article  PubMed  CAS  Google Scholar 

  7. Leitschuh M, Cupples LA, Kannel WB, et al. High-normal blood pressure progression to hypertension in the Framingham Heart Study. Hypertension 1991; 17:22–27.

    PubMed  CAS  Google Scholar 

  8. Vasan RS, Larson MG, Leip EC, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet 2001;358:1682–1686.

    Article  PubMed  CAS  Google Scholar 

  9. Wood D, DeBacker G, Faergeman O, Graham I, Mancia G, Pyorala K. Prevention of coronary heart disease in clinical practice: summary of recommendations of the second joint task force of European and other societies on coronary prevention. J Hypertens 1998;16:1407–1414.

    Article  PubMed  CAS  Google Scholar 

  10. Kannel WB, Dannenberg AL, Abbott RD. Unrecognized myocardial infarction and hypertension: the Framingham Study. Am Heart J 1985;109:581–585.

    Article  PubMed  CAS  Google Scholar 

  11. Verdecchia P, Carini G, Circo A, et al. Left ventricular mass and cardiovascular morbidity in essential hypertension. The MAVI Study. J Am Coll Cardiol 2001;38:1829–1835.

    Article  PubMed  CAS  Google Scholar 

  12. Kannel WB. Vital epidemiologic clues in heart failure. J Clin Epidemiol 2000;53:229–235.

    Article  PubMed  CAS  Google Scholar 

  13. Pannier B, Brunel P, Aroussey WE, et al. Pulse pressure and echocardiographic findings in essential hypertension. J Hypertens 1989;7:127–132.

    Article  PubMed  CAS  Google Scholar 

  14. Garden JM, Gottdiener JS, Wong ND, et al. Left ventricular mass in the elderly. The Cardiovascular Health Study. Hypertension 1997;29:1095–1103.

    Google Scholar 

  15. Post W, Larson MG, Levy D. Impact of left ventricular structure on the incidence of hypertension. The Framingham Heart Study. Circulation 1994;90:179–185.

    PubMed  CAS  Google Scholar 

  16. Davidman M, Opsahl J. Mechanisms of elevated blood pressure in human essential hypertension. Med Clin North Am 1984;68:301–320.

    PubMed  CAS  Google Scholar 

  17. Hachamovich R, Sonnenblick EH, Strom JA, Frishman WH. Left ventricular hypertrophy in hypertension, and the effects of antihypertensive drug therapy. Curr Probl Cardiol 1988;13:375–421.

    Google Scholar 

  18. Seshardri S, Wolf PA, Beiser A, et al. Elevated mid-life blood pressure increases stroke risk in elderly persons. The Framingham Study. Arch Intern Med 2001; 161: 2343–2350.

    Article  Google Scholar 

  19. Rutan G, McDonald RH, Kuller LH. A historical perspective of systolic vs diastolic blood pressure from an epidemiological and clinical trial viewpoint. J Clin Epidemiol 1989;42:663–673.

    Article  PubMed  CAS  Google Scholar 

  20. Franklin SS, Kahn SA, Wong ND, Larson MG, Levy D. Is pulse pressure useful for predicting coronary disease? The Framingham Heart Study. Circulation 1999; 100: 253–360.

    Google Scholar 

  21. Franklin SS, Larson MG, Kahn SA, et al. Does the relation of blood pressure to coronary heart disease change with aging? Circulation 2001; 103:1245–1249.

    PubMed  CAS  Google Scholar 

  22. Madhaven S, Ooi WL, Cohen H, Alderman MH. Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction. Hypertension 1994;23:395–401.

    Google Scholar 

  23. Chae CU, Pfeffer MA, Glynn RJ, Mitchell GF, Taylor JO, Hennekens CH. Increased pulse pressure and risk of heart failure in the elderly. JAMA 1999;281:634–639.

    Article  PubMed  CAS  Google Scholar 

  24. Psaty BM, Furberg CD, Kuller LH, et al. Association between blood pressure level and the risk of myocardial infarction, stroke and total mortality. The Cardiovascular Health Study. Arch Intern Med 2001; 161:1183–1192.

    Article  PubMed  CAS  Google Scholar 

  25. Lloyd-Jones DM, Evans JC, Larson MG, O’Donnel CJ, Levy D. Differential impact of systolic and diastolic blood pressure on JNC-VI staging. Hypertension 1999;34:381–385.

    PubMed  CAS  Google Scholar 

  26. Kannel WB, Wilson PWF, Silbershatz H. D’Agostino RB. Epidemiology of risk factor clustering in elevated blood pressure. In: Gotto AM, Lenfant C, Paoletti R, Eds. Multiple Risk Factors in Cardiovascular Disease. Dordrecht, The Netherlands: Kluwer Academic Publishers and Fondazione Giovanni Lorenzini; 1998:325–333.

    Google Scholar 

  27. Reaven GM. Insulin resistance, hyperinsulinemia, and hypertriglyceridemia in the etiology clinical course of hypertension. Am J Med 1991;90:7S–12S.

    Article  PubMed  CAS  Google Scholar 

  28. Anderson KM, Odell PM, Wilson PWF, Kannel WB. Cardiovascular disease risk profiles. Am Heart J 1990;121:293–298.

    Article  Google Scholar 

  29. Moore MA, Epstein M, Agoda L, Dwarkin LD. Current strategies for management of hypertensive renal disease. Arch Intern Med 1999;159:23–28.

    Article  PubMed  CAS  Google Scholar 

  30. Mimran A. Microalbuminuria in essential hypertension. Clin Exp Hypertens 1997;19:23–28.

    Google Scholar 

  31. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure JNC 7. JAMA2003;289:2560–2572.

    Article  Google Scholar 

  32. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. JAMA 1991;265:3255–3264.

    Article  Google Scholar 

  33. Staessen JA, Fagard R, Thijs L, et al. Randomized double blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. Lancet 1997;350:757–764.

    Article  PubMed  CAS  Google Scholar 

  34. Berlowitz DR, Ash AS, Hickey EC, et al. Inadequate management of blood pressure in a hypertensive population. N Engl J Med 1998;339:1957–1963.

    Article  PubMed  CAS  Google Scholar 

  35. Coppola WG, Whincup PH, Walker M, Ebrahim S. Identification and management of stroke risk in older people: a national survey of current practice in primary care. J Hum Hypertens 1997;11:185–191.

    Article  PubMed  CAS  Google Scholar 

  36. Kannel WB. Prospects for prevention of cardiovascular disease in the elderly. Prev Cardiol 1998;1:32–39.

    Google Scholar 

  37. Madhavan S, Ooi WL, Cohen H, Alderman MH. Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction. Hypertension 1994;23:395–401.

    PubMed  CAS  Google Scholar 

  38. Wolf PA, D’Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham study. Stroke 1991;22:312–318.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Kannel, W.B., Wilson, P.W.F. (2005). Epidemiology of Hypertension in the Older Patient. In: Prisant, L.M. (eds) Hypertension in the Elderly. Clinical Hypertension and Vascular Diseases. Humana Press. https://doi.org/10.1007/978-1-59259-911-0_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-911-0_5

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-197-4

  • Online ISBN: 978-1-59259-911-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics