Fluorescein Circulation Time and the Treatment of Hypertension in the Aged*

Abstract

An objective test for circulation time was performed in rabbits with the use of various dyes, of which the best was 10% fluorescein. The average circulation time in rabbits was 5–6 seconds. Serum from hypertensive patients injected intravenously into rabbits usually prolonged the circulation time. Differences in the results based on the age of the patients indicated a more benign type of hypertension in the elderly. An outline is given of the treatment of hypertension in the aged. Many cases respond fairly well to reassurance, a low‐salt diet, and weight reduction when the patient is obese. If additional measures are needed, diuretics are effective, especially furosemide (40 mg once or twice daily). In moderate or severe hypertension with renal parenchymal disease and a high level of blood urea nitrogen, methyldopa (250 mg two to four times daily) is of value. Potassium supplements should be given along with diuretics. In the Philadelphia Geriatric Center there are 325 residents, nearly all between the ages of 70 and 100; and more than 140 of them have hypertension. There are about 100 cases of depression (present or past), 75 cases of hiatal hernia (some with ulcer), and 53 cases of peptic ulcer. Since reserpine can aggravate peptic ulcer and can precipitate or aggravate depression, it should not be used to treat hypertension in the aged; nor should guanethidine be used for this purpose, since it can cause weakness and cerebrovascular insufficiency. High blood pressure should be reduced slowly in the aged, to avoid untoward effects.