Twenty‐four hour ambulatory blood pressure in a population of elderly men

Björklund K, Lind L, Lithell H (University of Uppsala, Uppsala, Sweden). Twenty‐four hour ambulatory blood pressure in a population of elderly men. J Intern Med 2000; 248: 503–512. Objectives. The principal aim was to study ambulatory and office blood pressure in a population of elderly men. We also wanted to describe the prevalence of hypertension and investigate the blood pressure control in treated elderly hypertensives. Design. A cross‐sectional study of a population of elderly men, conducted between 1991 and 1995. Subjects. Seventy‐year‐old men ( n = 1060), participants of a cohort study that began in 1970. Main outcome measures. Office and 24 h ambulatory blood pressure. Results. Average 24 h blood pressure in the population was 133 ± 16/75 ± 8 mmHg, and daytime blood pressure 140 ± 16/80 ± 9 mmHg. Corresponding values in untreated subjects ( n = 685) were 131 ± 16/74 ± 7 and 139 ± 16/79 ± 8, respectively. An office recording of 140/90 mmHg corresponded to an ambulatory pressure of 130/78 (24 h) and 137/83 mmHg (daytime) in untreated subjects. In subjects identified as normotensives according to office blood pressure ( n = 270), the 95th percentiles of average 24 h and daytime blood pressures were 142/80 and 153/85 mmHg, respectively. The prevalence of hypertension, defined as office blood pressure ≥ 140/90 mmHg, was 66%. Despite treatment, treated hypertensives ( n = 285) showed higher office (157/89 vs. 127/76 mmHg) and 24 h ambulatory (138/78 vs. 122/71 mmHg) pressures than normotensives ( P < 0.05). Fourteen per cent of the treated hypertensives had an office blood pressure < 140/90 mmHg. Conclusions. Our results provide a basis for 24 h ambulatory blood pressure reference values in elderly men. The study confirms previous findings of a high prevalence of hypertension at older age. It also indicates that blood pressure is inadequately controlled in elderly treated hypertensives.