The β-blocker efficacy in the treatment of heart failure and device-related complications necessitates long-term drug treatment. One bed elderly patient experienced a decline in blood pressure, with features such as 1.1 pathophysiological fluctuations in blood pressure. Hypertension in the elderly shows greater volatility compared to younger patients, particularly in systolic blood pressure, reaching up to 21.3kPa (160mmHg). In the past, if diastolic blood pressure (DBP) remained above 12.0 kPa (90mmHg), regardless of systolic blood pressure (SBP), hypertension could be diagnosed. Data indicate that in hypertensive populations aged 65 years and older, the incidence of heart disease and stroke is more than double that of others. Even under normal circumstances, DBP remains true. Women over 65 have a 40% higher incidence of cardiovascular disease compared to the average woman; men have a 70% higher incidence compared to the average male. This is mainly due to the close relationship between blood pressure fluctuations and high blood pressure, along with a decline in baroreceptor sensitivity for blood pressure regulation in older individuals.
Purely statistically analyzing eight cases of SBP hypertension within the SBP fluctuation range, the average was 61 ± 4.80 kPa (36mmHg), ranging from 2.67-17.3 kPa (20-130mmHg). Blood pressure fluctuations significantly impact the overall blood pressure level and treatment evaluation of patients. To this end, the author has studied the application of echocardiography for estimating systolic blood pressure altitude using normal blood pressure constants, left ventricular wall stress (SWS), and relative thickness (RWT) in patients with left ventricular hypertrophy. The projected value of SBP in patients showed significant correlation with actual average values (r = 0.866, P < 0.01), with an absolute difference of only 1.33kPa (10mmHg). Therefore, it is believed that SBP can be calculated more accurately to assess the severity of blood pressure levels in patients.
Barriers in the blood pressure regulation mechanism highlight 24-hour blood pressure fluctuations, often influenced by receptor changes, mood swings, and seasonal effects, causing systolic blood pressure differences of 2.67-5.33kPa (20-40mmHg). It is suggested that continuous monitoring of blood pressure achieved with 2-hour averages represents the 24-hour blood pressure mean better. The prognostic significance of blood pressure fluctuations remains unclear. Current data suggests that ECG left ventricular hypertrophy or complications are smaller with fewer blood pressure fluctuations. Existing data also indicates that older people with fewer blood pressure fluctuations show no special change in circadian rhythm, with peak blood pressure values occurring between 6Am and 10Pm, and low peak times occurring between 10Pm and 6Am. Understanding the circadian rhythm of blood pressure helps prevent complications, as about 40% of ischemic cerebrovascular diseases occur between midnight and 6Am, and myocardial infarction occurrence has two peaks at 8Am-9Am and 5Pm-6Pm.
Orthostatic hypotension is more common in elderly patients with hypertension, especially during antihypertensive therapy. Measurements in 20 patients lying down and passively standing for 2 minutes to 10 minutes revealed that approximately one-third of patients experienced orthostatic hypotension associated with dizziness and other symptoms, requiring extended time to return to baseline orthostatic blood pressure. Heart rate did not correspondingly change, except in two patients who showed orthostatic blood pressure changes when compared to supine positions. Orthostatic hypotension in elderly hypertensive patients correlates with age-related neurological and metabolic disorders. Excessive and rapid buckling may lead to severe cerebral insufficiency, making it difficult for pressure receptors to quickly adjust or create new job thresholds, which should be avoided.
Principles include understanding the difficulty in hardening of the arteries in the brain for elderly patients, where mercury sphygmomanometers measure vascular occlusion balloons, resulting in higher indirect pressure measurement readings, potentially differing by more than 4.00 kPa (30mmHg). If patients exhibit higher blood pressure readings without target organ involvement, such as no left ventricular hypertrophy shown on ultrasound electrocardiograms and lack of flexibility in pulse palpation, arm x-ray examinations may reveal vascular calcification. Antihypertensive treatment for these patients is not easily tolerated, leading to severe symptoms or complications.
Receptor sensitivity decreases with age, reducing the effects of exercise heart rate, blockers treatment, and decreased heart rate and blood pressure. Plasma renin activity (PRA) decreases cyclic adenosine monophosphate () concentration, while Q-receptor stimulation leads to platelet aggregation hyperthyroidism.