[Hypertension in old age (author's transl)].

At the present time there are certain hints, but no definitive evidence, that hypertension in old age raises mortality and morbidity. No proof has yet been advanced that antihypertensive therapy improves the prognosis of senile hypertension. For this reason it is quite conceivable that hypertension in old age merely indicates arteriosclerotic changes but does not essentially cause them, so that senile hypertension is an indicator of risk but not a risk factor. Antihypertensive drug therapy for persons over the age of 65 is consequently only justifiable at present on the grounds of analogy. It is to be recommended if hypertensive complications are already present in organs, if additional risk factors are demonstrable or if additional risk factors are demonstrable or if there is a markedly increased blood pressure. A treatment already begun in earlier years which is effective and has few side effects should be continued. Antihypertensive treatment in old age must be initiated with low doses and carefully increased so that in patients who are often symptomless at first, the reduction in blood pressure does not create more problems in a short time than the untreated hypertension does in the course of years.