Hypertension in the elderly

Current data indicate that most patients over age 60 with systolic blood pressure greater than 160 mm Hg and diastolic blood pressure greater than 90 mm Hg should be treated. The current data support the use of a thiazide and potassium-sparing diuretic with the addition of a centrally acting antiadrenergic drug as needed to reduce the blood pressure to less than 160/90 mm Hg. This will reduce the morbidity and mortality, especially cerebrovascular events, severe congestive heart failure, development of severe or accelerated hypertension, nonfatal myocardial infarction, and sudden death. Those unable to take these medications or who do not have satisfactory reduction in blood pressure should have other antihypertensive drugs added or substituted to lower blood pressure to less than 160/90 mm Hg.