TAILORING ANTIHYPERTENSIVE TREATMENT IN THE ELDERLY

The treatment of hypertension in the elderly has to take into account co-existing pathology. However, the benefit from treatment are large i n terms owing to the frequency of cardiovascular events in the elderly . The benefits observed in randomised controlled trials are reviewed t ogether with the adverse effects of the individual treatments. The opt imal use of anti-hypertensive treatment is considered in light of any concomitant disease; for example beta-blockers or calcium channel bloc kers when angina is present and the avoidance of diuretics in the pres ence of gout. Important hazardous drug interactions are also discussed . It is concluded that diuretics are still the first choice in uncompl icated hypertension and the least expensive. However the place of anti -hypertensive treatment is not established in those over the age of 80 years.