ASYMPTOMATIC CEREBROVASCULAR DAMAGES IN ESSENTIAL-HYPERTENSION IN THEELDERLY

To investigate the underlying mechanisms of asymptomatic cerebrovascul ar damage, the diurnal change in blood pressure was evaluated in hyper tensive patients with silent cerebral infarction (SCI). Sixty elderly hypertensive patients (age greater than or equal to 60 years) were mat ched with 40 middle-aged patients (age less than or equal to 59 years) for sex and left ventricular mass index (LVMi). Lacunar lesions were evaluated by magnetic resonance imaging as SCI. The presence and the s everity of SCI increased with age. In the middle-aged group, the prese nce of SCI was significantly related to 24-h blood pressure and LVMi e valuated by echocardiography. In elderly patients, the presence of SCI had no relationship with 24-h blood pressure or LVMi. The lowest leve l of nocturnal diastolic blood pressure showed a J-shaped relationship with the incidence of SCI in the elderly patients. These findings ind icate that the hemodynamic characteristics underlying the development of SCI differ between middle-aged and elderly hypertensive patients. A different approach to the treatment of hypertension in the elderly ap pears necessary. (C) 1997 American Journal of Hypertension, Ltd.