Hypertension in very old subjects

The role of hypertension as a risk factor for mortality and cardiovascular morbidity and the benefits of antihypertensive treatment are well establish ed in older patients up to 80 years. For people aged 85 and over, who are t he most rapidly growing segment of population in developed countries, data are scarce and conflicting. A positive association between blood pressure a nd survival has been found in several cohort studies, and this relation hel d true after adjustment for many factors. In randomized trials, the benefit s of antihypertensive treatment declined with age and were not observable a fter 80 years, with the exception of the SHEP study. People who reach a ver y old age share some characteristics which make them different from the bul k of "60 (or 65) and over" and justify special studies which are currently in progress. In the meantime, any treatment decision can only rely on extra polations moderated by common sense.