Hypertension: patient evaluation, indications for treatment.

Hypertension in older adults is a prevalent problem with significant morbid consequences, including cerebrovascular, cardiac, and renal disease. Recent studies have established a firm rationale for drug therapy in this population, and therapeutic developments have made effective treatment possible. Patient evaluation includes searches for secondary causes, risk factors for cardiovascular disease, and comorbidity. Antihypertensive therapy requires lifestyle interventions aimed at addressing overall cardiovascular risk factors. Drug therapy decisions are based on level of hypertension, side effects, and comorbid conditions. Older patients can be treated safely and effectively with any of the available antihypertensive agents, but drug selection should be individualized.