J Med Assoc Thai 1998; 81 (4):243

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Hypertension in the Elderly : A Community Study
Assantachai P Mail, Watanapa W , Chiempittayanuwat S , Thipanunt P

Hypertension in the elderly features differently from its younger counterpart in terms of
diagnosis, associated condition, atypical manifestation, management and complication. Epidemiological
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 sphygmomanometer.
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 hypertension,
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 respectively.
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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