scholarly journals AMBULATORY BLOOD PRESSURE MONITORING INDICATORS IN MIDDLE-AGED AND ELDERLY HYPERTENSIVE PATIENTS UNDER COMBINED ANTIHYPERTENSIVE THERAPY

Author(s):  
V.S. Pasko

It is known that arterial hypertension affects 30-35% of adult population of industrialized countries, and its prevalence reaches 40-50% among the elderly. In recent years, the issue of optimizing of treatment of hypertension in elderly people has been discussed such as choice of effective antihypertensive drugs with the least number of side effects, prevention of complications, reduced mortality, improvement of quality of life. The aim of the study was to substantiate the antihypertensive efficacy of the combination of enalapril and amlodipine in middle-aged and elderly hypertensive patients. Material and methods. Indices of ambulatory blood pressure monitoring were identified in 57 middle-aged patients (45-59 years) (group I) and 43 elderly patients (60-74 years) (group II), who underwent two-week in-patient treatment. All patients received the combined antihypertensive therapy (enalapril 10 mg twice daily and amlodipine 5 mg daily) for 2 weeks. And they were divided into 2 groups of 24 hours day's profile of blood pressure: dippers and non-dippers. Results. The combination of enalapril and amlodipine in elderly patients reduced the average daily diastolic blood pressure by 20,3% (p<0,05). Instead, in middle-aged patients there was the decrease in the average daily and the maximal daily systolic blood pressure by 17,3% (p<0,001) and 7,8% (p<0,05) and diastolic blood pressure respectively − by 23,2% (p<0,001) and 11,8% (p<0,05). Conclusions. Therefore, combined antihypertensive therapy in the elderly for 14 days was insufficient to improve significantly ambulatory blood pressure monitoring indicators. Obviously, positive changes require longer treatment.

Author(s):  
V.S. Pasko

The aim of the study was to determine the peculiarities of ABPM indices in middle-aged and elderly hypertensive patients depending on the daily BP profile. Material and methods. Indices of ambulatory blood pressure monitoring were identified in 57 middle-aged patients (45-59 years) (group I) and 43 elderly patients (60-74 years) (group II), who underwent two-week in-patient treatment. The control group consisted of 15 patients for every of the surveyed categories (group III - middle-aged and group IV – elderly respectively) matched with basic by age and gender. Results. We have shown that one of the factors that determines the change in hemodynamics in patients with essential hypertension is age, with the age patients experience the decrease in diastolic blood pressure with steadily increased systolic blood pressure, that should be considered in the prescription of antihypertensive treatment. With age, a gradual increase in systolic blood pressure is associated with the increased aortic stiffness, partially with the increase in collagen and the decrease in elastic fibrils and the formation of isolated systolic hypertension. Thus, it is proved that in the formation of isolated hypertension the growth of pulse blood pressure for more than 60 mm Hg is unfavorable in a development of cerebrovascular events. Pulse arterial blood pressure was stronger risk factor than systolic blood pressure and diastolic blood pressure or average arterial pressure in the elderly. Recently, taking into account age characteristics, all three indices were recognized as comparable predictors at the age of 50-59 years as the transitional period, and at the age of 60-79 years diastolic blood pressure adversely affecting the cardiovascular risk, increased pulse blood pressure prognostically above the level of systolic arterial pressure.


Gerontology ◽  
1992 ◽  
Vol 38 (1-2) ◽  
pp. 99-104 ◽  
Author(s):  
Olivier Raccaud ◽  
Bernard Waeber ◽  
Antonio Petrillo ◽  
Paul Wiesel ◽  
Jean-René Hofstetter ◽  
...  

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