Treating hypertension in the elderly

Hypertension is a common problem in the elderly with a prevalence of about 50%. The risk of cardiovascular disease and death is increased in hypertensive patients aged 60-79 years whereas this Increased risk seems to be diminished or even non-existent in those aged ≥ 80 years. Antihypertensive drug treatment has been shown to be beneficial for most elderly patients but whether this is also true for the oldest patients is less clear. Treatment is more difficult in the elderly than in the middle aged or young because of the structural and functional alterations of the cardiovascular system associated with ageing (in particular the impairment of BP homeostasis), which contraindicate some drugs and impose a cautious use of the remaining ones. Isolated systolic hypertension increases the cardiovascular risk but we lack data on the efficacy of treatment in this group.