Treatment of hypertension in the aged

: Previous studies carried out on the treatment of hypertension in the elderly patient indicate that, in this group of patients, antihypertensive treatment can reduce cardiovascular mortality mainly by reducing mortality from cerebrovascular diseases. To date, the success of hypertensive treatment in over-80-year-olds with uncomplicated hypertension, and patients with isolated systolic hypertension, has not been documented. In the treatment of the elderly patient, age-specific pathophysiological changes need to be taken into account. Such changes are deteriorating renal performance, increased vasoconstriction, decreasing baroreceptor function, declining cardiac performance, and changes in the autoregulation of cerebral blood flow. For this reason, in geriatric hypertensives, the blood pressure should be reduced gradually over a period of weeks. Antihypertensive drugs with a natriuretic or vasodilative effect are pathophysiologically meaningful, while substances that result in a loss of potassium, depression of the sympathetic nervous system and negative inotropism are not so favorable.