ABSTRACT
Hypertension is a common problem, especially in the elderly, yet it is often under-recognised and under-treated. Data from the Framingham Heart Study found that it had a prevalence of 27% in those below age 60 years, rising to 63% of those aged 60-79, and 74% in those aged over 80. 1 Only 32% of hypertensive subjects were on adequate treatment to control their blood pressure (BP) below 140/90 mmHg. Even normotensive people aged 55-65 years have a 90% chance of developing hypertension at some stage in their lifetime. 2 Isolated systolic hypertension (ISH) is defined as having a systolic BP above 140 mmHg with a diastolic below 90 mmHg. It appears to be particularly common in the elderly, probably due to an increase in stiffness of large arteries. 3 This is mediated by a reduction in elastin and an increase in collagen proteins plus calcification within vessel walls. The result is a widening of the pulse pressure.
