CLINICAL FEATURES AND TREATMENT APPROACHES FOR ARTERIAL HYPERTENSION IN ELDERLY PERSONS: RESULTS OF A PROSPECTIVE STUDY

Arterial hypertension (AH) in elderly persons differs by a number of pathophysiological and clinical features that substantially influence choice of therapeutic tactics and prognosis. Objective. To investigate clinical characteristics, the pattern of target-organ damage, and the effectiveness of antihypertensive therapy in elderly patients with AH compared with middle-aged subjects. Materials and methods. The prospective study included 136 patients with grade II–III AH: an elderly group (65–80 years, n=68) and a middle-age group (45–64 years, n=68). Twenty-four-hour ambulatory blood pressure monitoring (ABPM), echocardiography, carotid artery ultrasound, pulse wave velocity (PWV) assessment, and biochemical blood tests were performed. The follow-up period was 12 months. Results. Isolated systolic hypertension (ISH) was recorded significantly more often in the elderly — 60.3% versus 17.6% (p<0.001); pronounced orthostatic hypotension — 29.4% versus 8.8% (p<0.01); and a pathological “non-dipper” 24-hour profile — 61.8% versus 38.2% (p<0.01). PWV values (11.4±2.1 versus 8.6±1.7 m/s, p<0.001) and left ventricular mass index (LVMI, 142.3±24.6 versus 118.7±21.3 g/m², p<0.001) were significantly higher in the elderly group. After 12 months of therapy, target BP was achieved in 57.4% of the elderly versus 72.1% of middle-aged patients (p=0.04).

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