THE TREATMENT OF HYPERTENSION IN OLDER-PEOPLE AND ITS EFFECT ON COGNITIVE FUNCTION

The benefits of antihypertensive drug therapy for older people have be en clearly established. Meta-analysis suggests a 12% reduction in all- cause mortality, a 20% reduction in coronary heart disease and a 36% r eduction in stroke. The absolute benefits of treatment are great due t o the high incidence of vascular disease among older people. Clinician s may nevertheless have been deterred from initiating treatment becaus e of concerns regarding adverse effects on cognition, mood, functional ability and quality of life. Recent evidence from randomised controll ed trials suggests that these concerns are groundless. In the light of this evidence it is therefore disturbing that up to 50% of all older people with hypertension may remain untreated; and in over 50% of thos e who are treated, blood pressure may be inadequately controlled.