Raised blood pressure in the aged - to treat or not to treat

Abstract

There is still doubt in the over 65s as to what constitutes hypertension and whether or not it should be treated. With advancing age there is a gradual increase in systolic blood pressure in both sexes. The first difficulty is to decide what is normal; if only modest improvements in morbidity and mortality can be shown from normalising high blood pressure, the benefits cannot be regarded as certain unless side effects of the therapeutic agents are less hazardous than the anticipated risks of the untreated state. The reaction to hypotensive drugs may nary because of age effects on the regulation of blood pressure through the baroreceptor reflex. Aging also affects pharmacokinetics and pharmacodynamics. A few studies of the treatment of hypertension in the elderly are discussed.