Key factors in the treatment of the elderly hypertensive.

Cardiovascular diseases are of fundamental importance in the cause of death and morbidity in the elderly as a group. If the successful management of blood pressure can effect a reduction in morbid events as well as death, as has been indicated by recent trials, the elderly have more to gain than any other group within the population by adequate treatment of blood pressure. The physiologic response to aging in the cardiovascular system has characteristics similar to a beta-adrenergic blocking effect. Some similar changes are seen in older hypertensives. Hypertension may represent premature aging in the cardiovascular system. Blood pressure can be reduced in elderly people, and it is now relevant to determine whether one particular method of reducing blood pressure has advantages over others. Education of the elderly as to the advantages of treatment is important, but education of professionals who prescribe is, perhaps, more important. A clear understanding of the gains to be made and the side effects of different groups of drugs is necessary to allow the doctor to prescribe confidently for the elderly patient.