Essential Hypertension in an Elderly Woman: a Case Report

Abstract

Hypertension is one of the leading risk factors for cardiovascular disease, with a continuously increasing prevalence among the elderly, yet many cases remain undiagnosed or inadequately controlled. A 75-year-old woman presented with headache accompanied by difficulty sleeping for one day prior to examination, with a previously measured elevated blood pressure but no history of antihypertensive treatment. Physical examination revealed a blood pressure of 166/90 mmHg and a body mass index of 25.3 kg/m² (overweight), without signs of target organ damage or clinical findings suggestive of a secondary etiology. Identified risk factors included advanced age, insufficient rest, coffee consumption, a diet high in salt and fat, low physical activity, and a family history of hypertension. Grade 1 essential hypertension was diagnosed based on history and physical examination. Management included amlodipine, education, and dietary sodium restriction combined with increased physical activity. At the following follow-up visit, blood pressure decreased to 140/85 mmHg, accompanied by symptomatic improvement and patient-reported adherence to the recommended dietary and physical activity changes. This case illustrates that acute symptom relief and blood pressure reduction can be achieved through a combination of antihypertensive monotherapy and lifestyle education in an elderly patient, although the target blood pressure of <130/80 mmHg was not yet fully achieved at that evaluation.