Hypertension in the Elderly: Hypertension Seminars at Östra Hospital, Göteborg, Sweden

A review on the effects of ageing on cardiovascular function, with special reference to high blood pressure (BP), is given in this seminar. In most western populations the diastolic and especially the systolic BP increases with age in both sexes and this has been observed both in cross-sectional and longitudinal studies. Over the age of 60 the diastolic BP decreases. Of the different risk factors for cardiovascular diseases, only BP has been shown consistently to be an independent risk indicator in subjects 70 years or older. Hypotensive drugs used in the treatment of middle-aged hypertensive patients can also reduce the BP in elderly hypertensive patients can also reduce the BP in elderly hypertensive patients but are likely to produce more adverse reactions such as electrolyte disturbances and glucose intolerance by thiazides, depression by reserpine, orthostatic hypotension by methyldopa and excessive bradycardia by beta-blockers. A prolongation of life expectancy in hypertensive patients 60 years or older by hypotensive drug therapy has not been shown conclusively in controlled trials.