American Board Of Family Medicine (ABFM) ITE Practice Test

What is an expected physiologic change in elderly patients?

Reduced heart rate variability Decreased arterial compliance Lower systolic blood pressure Wider pulse pressure

Correct Answer:

Wider pulse pressure

Explanation:

As people age, large arteries become stiffer due to structural changes in the vessel wall. This arterial stiffening reduces the aorta’s ability to recoil during systole, so systolic blood pressure tends to rise. Diastolic pressure tends to stay the same or decline a bit, which widens the gap between systolic and diastolic pressures. That widening is the pulse pressure, and it becomes more pronounced in the elderly. For example, going from about 120/80 to something like 150/85 illustrates the increased pulse pressure. This arterial stiffness-driven change is the classic, expected physiologic pattern in aging. While other age-related changes exist (such as some reduction in heart rate variability), the hallmark finding is a wider pulse pressure.

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