Crimson Publishers High Impact Journals

Friday, July 17, 2020

Essential Hypertension in the Elderly: To Treat or Not to Treat? A Therapeutic Dilemma for the Geriatric Cardiologist_ Crimson Publishers


Essential Hypertension in the Elderly: To Treat or Not to Treat? A Therapeutic Dilemma for the Geriatric Cardiologist by Akhtar Khan* in Open Journal of Cardiology & Heart Diseases_ journal of cardiology & heart diseases

 

Abstract
Essential hypertension, the most common type, is an important cause of morbidity and mortality in the elderly, a rapidly growing section of the population. It is a sad reality that until the 1950s treating benign hypertension was not thought to be necessary. The tragic death of Franklin Delano Roosevelt on April 12, 1945 at the age of 63 years, with a blood pressure of 350/195mmHg, and without treatment shocked the healthcare community. Now, with extensive research, the availability of affordable and effective treatments and lifestyle measures, freedom from unfounded phobias of adverse drug effects, and new approaches such as aroma, colour and music therapy have improved the quality of life for hypertensives generally and especially the elderly.

Introduction
“There are few stories in the history of medicine that are filled with more errors or misconceptions than the story of hypertension and its treatment.“_ Prof Marvin Moser (1925-2015)-Yale University School of Medicine.

Hypertension (HTN) is defined as: Having a systolic blood pressure (SBP) of 140mmHg or greater OR having a diastolic blood pressure (DBP) of 90mmHg or greater OR taking antihypertensive medication OR having been told at least twice by a physician or other health professional that one has HTN [1]. Prof. John Hay (University of Liverpool), while delivering a lecture in Bradford on February 25th, 1931, under the auspices of the British Medical Association, remarked “It is agreed that a high arterial pressure is essential for the efficient performance of muscular work”. He added “There is some truth in the saying that the greatest danger to a man with high blood pressure lies in its discovery, because then some fool is certain to try and reduce it [2]. However, research has since established that HTN (“The Silent Killer”) is a persistent non-physiologic elevation in blood pressure necessitating timely pharmacological and non-pharmacological interventions. Essential hypertension (‘Essentielle hypertonie’) is the most common type of HTN accounting for 95% of hypertensives.


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