5.Hypertension in elderly utk kuliah
-
Upload
aliff-halimie -
Category
Documents
-
view
218 -
download
0
Transcript of 5.Hypertension in elderly utk kuliah
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 1/11
HYPERTENSION IN THE ELDERLY
Hasyim Kasim
Prof DR.Dr.Syakib Bakri
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 2/11
ELDERLY
> 65 YEARS
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 3/11
BLOOD PRESSURE CLASSIFICATION
JNC 6 – 1997 JNC 7 - 2003
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 4/11
PhysicalPhysical
ExaminationExaminationAccurate measurement of blood pressure
General appearance : distribution of body fat, skin lesions,
muscle strength, alertness
FunduscopyNeck : palpation and auscultation of carotids, thyroid
Heart : size, rhythm, sounds
Lungs : rhonchi, rales
Abdomen : renal masses, bruits over aorta or renal arteries,
femoral pulses, waist circumference
Extremities : peripheral pulses, edema
Neurologic assessment, including cognitive function
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 5/11
Blood Pressure MeasurementBlood Pressure Measurement
• Patients should be seated with back supported and arm bared and
supported.
• Patients should refrain from smoking or ingesting caffeine for 30
minutes prior to measurement.
• Measurement should begin after at least 5 minutes of rest.
• Appropriate cuff size and calibrated equipment should be used.
• Both SBP and DBP should be recorded.
• Two or more readings should be averaged.
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 6/11
POPULATION : Notice the increase in the
elderly population as the baby – boomers age
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 7/11
PERCENT ELDERLY BY AGE 2000 – 2030
IN AMERICA ( U.S. CENCUS 2000 )
0
5
10
15
20
25
2000 2015 2030
> 65
> 75
> 80
21,9% 25,2% 35,1%
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 8/11
INDONESIAN ELDERLY POPULATION
( > 65 YEARS )
Ind. Cencus 1971, 1980, 1990, 1995 and 2000
0
1
23
4
5
67
8
9
10
1971 1980 1990 1995 2000
>65
years
Biro Pusat Statistik
Indonesia
2,51%3,25%
3,88%4,25%
4,75%
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 9/11
Aging is NOT a disease
Aging is a universal process.
Many elderly have arthritis, ordementia, or hypertension
But not everyone gets the samedisease
Disease is not a necessary part of aging
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 10/11
Principal Effects of
Aging on the Cardiovascular System
• Increased arterial stiffness
• Increased myocardial stiffness
• Impaired β-adrenergic responsiveness
• Impaired endothelial function• Reduced sinus node function
• Decreased baroreceptor responsiveness
• Net effect: Marked reduction in CV
reserve
8/7/2019 5.Hypertension in elderly utk kuliah
http://slidepdf.com/reader/full/5hypertension-in-elderly-utk-kuliah 11/11
Systolic BP rises continuously with age
Diastolic BP rises continuously until age 60-70years
It falls thereafter as a consequence of increased arterial stiffness
Systolic HypertensionPulse pressure increases continuously with
age
Smulyan H, Safar ME. Ann Intern Med . 2000;132:233-237.