[Current aspects of arterial hypertension: hypertension in the aged].
HIGH PREVALENCE: In France, an estimated 5 million persons aged over 65 years have hypertension. Accepting a treatment threshold of systolic pressure 160 mmHg whatever the diastolic pressure, more than 3 million require antihypertension therapy.


METHODS
During the aging process, the arterial trunks progressively loose their elasticity, becoming more and more rigid. Other age-related modifications of the vascular bed, as well as environmental factors (diet, sodium intake) also play a role.
Several meta-analyses have demonstrated that active antihypertensive therapy can reduce overall mortality by 12%, the risk of cerebral vascular events by 36% and cardiac events by 25%. The risk of non-fatal cerebral vascular events can be reduced by 35%.
Repeated blood pressure measurements are needed. Measurements should be made well after meals and take into account possible overestimation related to the rigidity of the humeral artery.
Moderate salt intake and antihypertension drugs should be prescribed. A single drug regimen can be advised for initial treatment, avoiding long-action or high-dose regimens. Episodes of hypotension should be suspected if patients complain of malaise.
Belmin
J
J
Service de Médecine Interme Gériatrique et Université Paris Nord, Hôpital René Muret-Bigottini, Sevran.
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence