Hypertension in the Elderly : A Community Study
PRASERT ASSANTACHAI, M.D., M.R.C.P.(UK)*, WATT ANA WATANAPA, M.D., Ph.D.**, SOMCHAI CHIEMPITTAYANUWAT,M.Sc.**, PORNPUN THIPANUNT,B.N.***
Affiliation : * Department of Preventive and Social Medicine, ** Department of Physiology, *** Department of Nursing, Faculty of Medicine, Siriraj Hospital, Bangkok 10700, Thailand.
Abstract Hypertension in the elderly features differently from its younger counterpart in terms of diagnosis, associated condition, atypical manifestation, management and complication. Epi- demiological study in this increasing age group in the community is, therefore, needed. 334 elderly subjects living in various parts of Bangkok were randomly recruited by appointment at 7 geriatric day centers situated in local health offices of Bangkok Metropolitan Authority. Each subject received blood tests before being interviewed and measured by digital sphygmo- manometer. Blood pressure and heart rate changes were recorded during lying, sitting and standing. The prevalence of hypertension was 36.5 per cent, 33.2 per cent were already aware of its existence while 3.3 per cent were newly detected by the survey. Isolated systolic hyper- tension, a unique subtype found in the elderly, was 4.5 per cem of all or 37.5 per cent among the hypertensive group. The associated medical conditions among the case group were diabetes mellitus 22.9 per cent, hyperlipidemia 13.9 per cent, hyperuricemia 33.3 per cent and heart disease 18.0 per cent. As far as postural hypotension is concerned, 14.8 per cent of case group whereas 11.3 per cent of the control group were affected. On the other hand, the symptom of postural dizziness was found to be 31.1 per cent and 55.2 per cent in the case and control group res- pectively. Following the statistical logistic regression analysis, the independent associated factors in the hypertension group were: history of hyperlipidemia, increased serum uric acid and poor heart rate response after standing. These findings, as parts of the multiple pathology and potential complications prevalent among this group, should be of concern by any physician looking after the elderly.
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