Age-related physiologic differences such as wider pulse pressure should be a consideration when treating hypertension in the elderly.
Compared to younger patients, elderly patients have:
- Lower cardiac output,
- higher peripheral resistance,
- lower intravascular volume, and
- lower renal blood flow.
- Wider pulse pressure
“Pulse pressure (the difference between systolic blood pressure and diastolic blood pressure) is a measure of the degree of age-related vascular stiffness and is a risk factor for coronary artery disease events.
With increasing age the strongest predictor of coronary artery disease gradually shifts from diastolic blood pressure to systolic blood pressure, and then to pulse pressure. Systolic blood pressure rises gradually throughout adult life, whereas diastolic blood pressure peaks and plateaus in late middle age, and declines slightly thereafter. Diastolic hypertension occurs in <10% of all patients with hypertension after age 70.” ABFM