The therapeutic dilemma of hypertension in the elderly.

There are good reasons to treat hypertension in the elderly. Elevated blood pressure at any age increases morbidity and mortality from cardiovascular disease. Treatment trials suggest that antihypertensive treatment in the elderly decreases strokes, may improve the cardiovascular morbidity, but does not prolong life. Consequently, elevated blood pressure in people over 65 years of age should be treated, but there is no justification for an overly aggressive approach. Knowledge of side effects of various drugs and appreciation of a patient's specific features permit individual 'tailoring' of the treatment and optimise the outcome. No present-day antihypertensive drugs are specific for the elderly. The drive to combat cardiovascular morbidity and mortality in the elderly continues. New drugs are under development and promise to further improve results.