9% of elderly hypertensive patients have a high rate of orthostatic blood pressure fluctuating senescence
Jul 22, 2024
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The prevalence of hypertension in Korea exceeds 50% in those in their 60s and 60% in their 70s and older, according to the 「2023 Factsheet」 published by the Korean Society of Hypertension.
Considering that the elderly population is growing at the fastest rate among major countries in the world, the number of elderly hypertensive patients in Korea is expected to increase even more steeply in the future.
Because such hypertension in the elderly is accompanied by abnormalities in several organs due to aging, overall evaluation and comprehensive management are required, unlike hypertension in young age.
In response, the research team led a domestic multi-center study 'HOWOLD-BP' to find an optimal management model for hypertension in the elderly and conducted a study to find out the link between orthostatic blood pressure fluctuations and senility, cognitive decline, and deterioration of quality of life that threaten elderly health.
Orthostatic blood pressure fluctuations are symptoms in which blood pressure changes when changing from a lying position to a standing position, resulting in dizziness and falls (standby hypotension), or higher blood pressure (standby hypertension).
An abnormality in autonomic nervous system control is known to be the cause, and in Europe and the United States, it is recommended to perform tests on elderly hypertensive patients.
The research team analyzed the results after performing orthostatic blood pressure fluctuation tests on 2065 elderly hypertensive patients recruited from 12 national university hospitals in Korea participating in the HOWOLD-BP study.
As a result of the study, it was confirmed that 4.6% of elderly hypertensive patients had orthostatic hypertension and 4.1% had orthostatic hypotension.
The proportion of orthostatic blood pressure fluctuations when combined is 9% of the total, and considering the number of elderly hypertension populations estimated to be more than 5 million in Korea, hundreds of thousands of people are at risk.
In addition, the research team confirmed that among them, hypertensive patients with orthostatic hypertension had a high percentage of senility. In elderly hypertensive patients with normal orthostatic blood pressure fluctuations, the pre-aging stage was 23% and the aging stage was 4%, while in the case of orthostatic hypertensive patients, the pre-aging stage was 38% and the aging stage was 8%, which was significantly higher than the control group.
In addition, patients with orthostatic hypertension recorded low scores in the cognitive function evaluation, confirming that orthostatic hypertension is also related to cognitive decline such as dementia, and the quality of life survey also showed that the score was lower than that of the control group in terms of ▲ daily activity maintenance ▲ exercise ability ▲ pain ▲ discomfort.
Professor Kim Kwang-il said, `Considering the reality in Korea that is about to enter a super-aged society, the number of elderly hypertensive patients is expected to increase rapidly in the future"As the study revealed that there is a strong association between orthostatic blood pressure changes, senility, and cognitive decline among elderly hypertension patients, it is necessary to prepare an optimal blood pressure management strategy for each patient's characteristics by considering these factors."," he said.
The study was conducted with the support of the National Institute of Health and was published in the official journal of the American Heart Association, 'Hypertension' (IF 8.3). In addition, it was presented at the '2024 European Society of Hypertension', a global prestigious academic conference held in Berlin from May 31 to June 3, drawing attention from academia.
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