Care of Elderly Patients in a Special Hypertension Clinic

In a special hypertension clinic, 35 hypertensive elderly men (mean age, 72 years) and 29 hypertensive younger men (mean age, 45 years) were studied. In the clinic, nurse-clinicians evaluated and treated the patients under physician supervision, and compared the findings in the two groups. The same success in blood pressure control was achieved in both groups. Syncope or serious dizziness was uncommon in either group. A slight rise in the serum creatinine level over time was observed in both the older and the younger patients, but was greater in the elderly (mean increment 0.27 mg/dl, elderly; 0.096 mg/dl, younger). Compliances with medication schedules (diuretics, or a diuretic and methyldopa) were equally good in the two groups. The rates of required clinic visits were the same, but the elderly had a better attendance record. It is concluded that the treatment of elderly hypertensive patients is feasible and may be carried out in a focused "hypertension clinic." Including older persons in such programs can be expected to result in their protection from cardiovascular complications, as well as other indirect health benefits.