Publication:

Profile of vascular age and vascular response among elderly patients receiving antihypertensive therapy

Background Normally the age of the arteries is same as that of the chronological age of the patient. In Hypertensive patients, complex interactions occur between prohypertensive factors, accelerating vascular age. Furthermore, prohypertensive factors to some extent are responsible for non-response to therapy at optimal doses. We assessed the correlation between response to therapy and vascular age in elderly hypertensives, in addition to vascular age and vascular response.

Methods In this study, we analysed the clinical records of both male and female hypertensive patients above 60 years old. We collected the details of age, gender, body mass index, systolic blood pressure (treated and untreated), diabetes and smoking. Vascular age was calculated using a composite score of these six prohypertensive risk factors. Accelerated vascular age was then derived using the formula vascular age minus chronological age. The optimal vascular response was considered if the patient's therapeutic blood pressures are less than 140/ 90mmHg.

Results In the present study, data from 517 elderly hypertensive patients were analysed, the mean chronological age, vascular age and accelerated vascular age was 66.74±6.6, 79.46±0.42 and 13.46±6.08 years. Only 32.7% were responders to anti-hypertensive treatment. The pattern of usage of anti-hypertensives in our patients is CCBs 39.10% followed by 30.90% ARB, 22.50% ACEI and 8.90% diuretics. The response in 20.50% of patients was achieved with a single drug, in 9.90% with two drugs and only in 2.30% of patients using three drugs. We found that 78.72% of our study population had vascular age more than ten years of chronological age, among them 66.6% between 60-69 years of chronological age were non-responders. We found a significant correlation (P<0.05) between vascular age and non-response to treatment.

Conclusions The majority (98.6%) of our patients had vascular age more than 80 years due to various risk factors of cardio vascular disease. Non-responsiveness to therapy showed a significant relationship with vascular age.