What Can We Learn From the American Heart Association and American College of Cardiology Expert Consensus Document on Geriatric Hypertension?

Abstract

The expert consensus document in the elderly 1 is designed to cover topics that have incomplete evidence-based information regarding clinical practice, and therefore often must be altered significantly on the basis of future randomized controlled trials (RCTs). Hence, it is not uncommon for consensus documents to have both strengths and potential weaknesses.For example, the guidelines stress the importance of using 24-hour ambulatory blood pressure (BP) measurement as the ideal method of diagnosing both masked and white-coat hypertension 1 ; indeed, errors of detection are magnified in the elderly population with isolated systolic hypertension (ISH) because of increased BP variability contributing to white-coat hypertension and white-coat effect. The consensus statement 1 emphasizes these points but neglects to mention that recruitment of elderly subjects for RCTs exclusively by clinic BP will perpetuate the inclusion of those with white-coat hypertension and excessive white-coat effect and exclude those with masked hypertension.

Nutrition and hydration education on healthy fasting for pedicab drivers community in Yogyakarta

“…In old age, several degenerative diseases often occur, one of which is hypertension. Hypertension in the elderly is divided into hypertension where systolic pressure is equal to or greater than 140 mmHg and or diastolic pressure is equal to or greater than 90 mmHg, and isolated systolic hypertension where systolic pressure is greater than 160 mmHg and diastolic pressure is lower than 90 mmHg (Franklin, 2012). In this community service programme, most of the participants had hypertension as many as 12 people (27.3%).…”