Treating hypertension in the elderly: protagonist viewpoint.
Cardiovascular disease is the main cause of serious illness and death in the United States. Increasing age is a strong predictor of cardiovascular events, driven largely by such major conditions as hypertension and diabetes mellitus. Systolic hypertension probably reflects progressive stiffening of large and small arteries; close to 90% of all Americans will have this diagnosis by their 80s. Regardless of age, systolic hypertension is a powerful risk factor for stroke, heart failure, and other cardiovascular outcomes. Treating hypertension in the elderly sharply decreases the probability of these events. Clinical trial evidence does not include patients with stage 1 systolic hypertension (140-159 mm Hg), although the results in stage 2 are so convincing that it is very reasonable (as concluded by national guidelines committees) to extrapolate benefits and recommend treatment to patients in the less-severe group. Whereas evidence of treatment benefits in patients aged 80 years and older is limited, sufficient octogenarians have been studied to confidently assert that strokes, at least, can be prevented. Another potentially important benefit that is yet to be fully confirmed is that treating hypertension in older people may also reduce the incidence of dementia.
Weber
Michael  A
M
State University of New York Downstate Medical College, USA. mweber@downstate.edu
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003704:Dementia / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome
D000959:Antihypertensive Agents