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Q J Med 2000; 93: 203-205
© 2000 Association of Physicians

Editorial

Controlling hypertension in the elderly

C.J. Bulpitt

Care of the Elderly, Imperial College School of Medicine, Hammersmith Campus, London

Hypertension is best defined as the level of blood pressure above which treatment does more good than harm. This information comes from the results of randomized controlled trials, i.e. the evidence base. However, we do not know the level of blood pressure at which treatment fails to confer an overall benefit. Such a level is predicted to exist, as at lower levels of blood pressure, few gain by having cardiovascular events prevented yet all are at risk of the adverse effects of treatment. At the beginning of 2000, we know that at most ages it is worth treating a systolic blood pressure >=160 mmHg and/or a diastolic blood pressure >=90 mmHg. This has not prevented speculation that treatment should be started at say, a systolic pressure of 140–159 mmHg.1,2 Nevertheless caution must be expressed that adverse effects may outweigh advantages in certain groups, for example the very elderly (>80 years) . . . [Full Text of this Article]

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O.M.P. Jolobe
Controlling hypertension in the elderly
QJM, October 1, 2000; 93(10): 700 - 701.
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