NATIONAL HIGH BLOOD-PRESSURE EDUCATION-PROGRAM WORKING GROUP-REPORT ON HYPERTENSION IN THE ELDERLY

Raised blood pressures in the elderly and the increased prevalence of hypertension in this population are not benign occurrences and should not be viewed as a normal or inevitable consequence of aging. In fact, the relation of systolic and diastolic blood pressures to cardiovascu lar events is generally more pronounced in people aged 65 years and ol der when compared with those aged 35 to 64. The relative risk of cardi ovascular disease is greater among the elderly at every level of blood pressure. Furthermore, the absolute likelihood that an older individu al will have a cardiovascular event is substantially greater than for someone younger, reflecting the increased prevalence of other cardiova scular disease risk factors in this age group. Thus, equivalent blood pressure reduction is likely to produce a greater benefit in the elder ly than in younger patients at every level of blood pressure. This rep ort, an update of the 1985 Working Group Report on Hypertension in the Elderly, has two aims: to guide clinicians in their care of elderly p atients with hypertension and to assist health care professionals part icipating in high blood pressure control programs that serve the elder ly. The role of lifestyle modifications-weight loss, dietary sodium re striction, alcohol reduction, and exercise-as definitive or adjunctive therapy to drug treatment is discussed. In addition, the report revie ws the relative advantages and disadvantages of the specific classes o f antihypertensive medications.