Prevalence of Hypotension in Elderly Patients with Hypertension Undergoing Antihypertensive Treatment

pp. 276-282

Abstract

Background: Hypotension due to antihypertensive treatment is one of the undesirable effects that can occur in elderly patients with hypertension.

Objective: The aim of this study was to assess the presence and frequency of hypotension—whether symptomatic or not—in patients over 65 years of age receiving antihypertensive therapy using 24-hour ambulatory blood pressure monitoring (ABPM).

Methods: We retrospectively analyzed ABPM data from 12 177 patients, resulting in a final sample size of 1457 studies, all conducted in subjects with isolated systolic hypertension. Fifty-nine percent were women, and mean age was 73.1 years. They were divided into three age groups: 65 to 69, 70 to 79, and over 80 years of age. Hypotension was considered present in four circumstances: daytime systolic blood pressure or 24-hour systolic blood pressure < 100 mmHg, or daytime mean blood pressure or 24-hour mean blood pressure < 73 mmHg, respectively.

Results: Among the 1457 studies analyzed, 57 reported hypotension, and in only 9 of them—15.8%—patients experienced symptoms such as dizziness and weakness. None reported syncope or falls. The mean (standard deviation) of blood pressure recordings for these 57 patients were: daytime mean systolic blood pressure: 98.9 (3.74) mmHg; 24-hour mean systolic blood pressure: 99.8 (3.44) mmHg; daytime mean blood pressure: 68.8 (4.08) mmHg; and 24-hour mean blood pressure: 73.6 (3.62) mmHg. Among the 1457 patients, 2.1 medications per patient were required for blood pressure control, with a predominance of combination therapy, whereas among the 57 patients who presented with hypotension, 43.9% were treated with a single medication and 56.1% with combination therapy. In 28.9% of cases, patients had associated comorbidities.

Conclusions: Our results demonstrated a low prevalence of hypotension in these elderly patients receiving antihypertensive treatment, as well as good blood pressure control.