PITFALLS TO AVOID IN THE MEASUREMENT OF BLOOD-PRESSURE IN THE ELDERLY

Accurate, reproducible blood pressure readings are more difficult to o btain in the elderly. Elderly patients have more variable blood pressu re, show a reduction in blood pressure following meals, and can have p ostural hypotension, discrepancies in blood pressure between arms, aus cultatory gaps and 'pseudohypertension', all of which can mislead clin icians regarding these patients' usual blood pressure. Arrhythmias, pa rticularly atrial fibrillation, make accurate blood pressure determina tion difficult and are more common in the elderly. Prostatic hypertrop hy causing high pressure urinary retention is suggested as a common an d reversible cause of hypertension in older men. Proper measurement of blood pressure in elderly patients demands additional thought and act ion, all of which are necessary for accurate cardiovascular risk asses sment and proper therapeutic decisions. Increasing the number of visit s and the number of carefully taken blood pressure readings per visit will result in a more accurate assessment of blood pressure in older p atients.