Influence of Comorbidities on Bp Goal

24 THE AMERICAN JOURNAL OF GERIATRIC CARDIOLOGY 2007 VOL. 16 NO. 1 H and its associated chronic complications remain considerable health issues in the United States. Hypertension is defined as systolic blood pressure (SBP) ≥140 mm Hg and diastolic blood pressure (DBP) ≥90 mm Hg.1 According to this definition, approximately 50 million adult Americans have hypertension, and three fourths of these individuals do not have controlled blood pressure (BP) (ie, <140/90 mm Hg).2,3 Many hypertensive Americans are elderly patients 65 years and older, and this specific population continues to grow. According to the US Census Bureau, there were 35 million Americans 65 years and older in the 2000 census, which represents a 12% increase since 1990.4 Furthermore, data from the National Health and Nutrition Examination Survey (NHANES)3 indicate that the prevalence of hypertension increases with age (present in 65.4% of NHANES respondents 60 years and older). Although the average DBP decreases with advancing age, the average SBP increases, and the prevalence of isolated systolic hypertension, therefore, is increased.5,6 Burt and associates7 estimated that only 20% of older people with hypertension are controlled at target BPs (SBP ≤140 mm Hg and DBP ≤90 mm Hg), which is attributed to poor control of SBP. As a consequence of elevated BP, elderly patients are at higher risk for myocardial infarction (MI) and stroke, among other complications. Elevated BP is a major risk factor that contributes to more than 500,000 strokes and 150,000 stroke deaths yearly in the United States and is also a major Prevalence of Comorbidities and Their Influence on Blood Pressure Goal Attainment in Geriatric Patients