Hypertention in the Elderly: To Treat or not to Treat / לחץ-דם גבוה בגיל הזקנה: האם לטפל?

The controversies concerning the treatment policy of hypertension in the elderly continues. One cannot escape the impression that those who advocate aggressive treatment may have an economic interest in it, with the drug companies in the background while, on the other hand, those who wish to stop the treatment may be accused of nihilistic attitude and neglect. On the ground of the literature and personal experience, we would like to advocate 1. To try to omit any treatment in "new" hypertension over the age of 75 years. 2. In any functional deterioration (e.g. falling, incontinence, confusion and failure to thrive), try to reduce or stop antihypertension medication. 3. All treatment in the elderly is empiric. It would be appropriate to have them in the first weeks under tight control in order to observe any functional decline due to one of the drugs.