Hypertension in older adults

The high prevalence of hypertension in older persons (nearly one of two sub jects aged 60 years and older) suggests that the recognition and treatment should he a priority fur physicians. Although diastolic blood pressure is r egarded as an important risk factor, it is now clear that isolated systolic hypertension and elevated pulse pressure also play an important role in th e development of cerebrovascular disease, congestive heart failure, and cor onary heart disease, which are the major causes of cardiovascular morbidity and mortality in the population aged older than 65 years. Controlled, rand omized trials have shown that treatment of systolic as well as systolodiast olic hypertension decreases the incidence of cardiovascular and cerebrovasc ular complications in older adults. The question of whether treatment of hy pertension should be maintained in very old persons, those older than 80 ye ars, is still undecided.