Home blood pressure profile in very elderly hypertensives: should we use the same thresholds as in younger patients?

J Am Soc Hypertens. 2015 Mar;9(3):184-90. doi: 10.1016/j.jash.2014.12.021. Epub 2015 Jan 6.

Abstract

We aimed to determine the characteristics of home blood pressure (BP) in very elderly hypertensives. A total of 485 treated hypertensive patients ≥18 years (median age, 70.8 [interquartile range, 18]; 67.2% women) underwent home BP measurements. Characteristics of patients ≥80 and <80 years of age and prevalence of office and home uncontrolled hypertension, isolated morning (IMH), isolated evening, isolated office, and masked hypertension were compared. Very elderly subjects had higher levels of systolic and lower levels of diastolic BP at home, a higher prevalence of home uncontrolled hypertension (68.5% vs. 37.7%; P < .001), masked hypertension (30.6% vs. 14.9%; P = .02), and IMH (19.4% vs. 10.9%; P = .02), and a lower prevalence of isolated office hypertension (8.3% vs. 18.8%; P = .01). When using differential home BP thresholds in the very elderly, determined through the percentile method, statistical differences disappeared, except for IMH. The very elderly depict a particular home BP profile. Benefit from using differential home BP thresholds should be determined in prospective studies.

Keywords: Home blood pressure; hypertension; monitoring; octogenarians.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use*
  • Argentina
  • Blood Pressure Determination / methods
  • Blood Pressure Monitoring, Ambulatory* / methods
  • Blood Pressure Monitoring, Ambulatory* / standards
  • Cross-Sectional Studies
  • Female
  • Frail Elderly
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy
  • Hypertension / physiopathology
  • Male
  • Patient-Centered Care / methods
  • Patient-Centered Care / standards
  • Prevalence

Substances

  • Antihypertensive Agents