[Age related hemodynamic changes in the elderly]

Abstract

Systolic blood pressure (SBP) increases by aging. In contrast, diastolic blood pressure (DBP) decreases after age 60 because of lowering aortic compliance. Therefore, isolated systolic hypertension (ISH) is common in the elderly. ISH is a risk for cardiovascular complications, and induces a left ventricular hypertrophy combined with diastolic dysfunction. Diastolic heart failure followed by diastolic dysfunction is more common than systolic heart failure in the elderly. Furthermore, changes in neuroendocrine systems by aging may lead orthostatic hypotension, non-dipping status, large blood pressure variability, and reduced heart rate variability. In the management of elderly hypertension, the understanding for these age-related hemodynamic changes is very important.