ABSTRACT
Elderly patients already complaining of transient spells of vertigo and ataxia are particularly likely to be started on antihypertensive medication, although arrhythmias are in fact much more likely causes of these symptoms than high blood pressure. Elderly people vary enormously in their biological rather than chronological ages, in their accumulated burdens of diverse organ damage, and their reasonable fears of other causes of death. About half the people treated for high blood pressure in Britain are aged 65 or over. Thiazide diuretics are almost always a best choice for treatment of high blood pressure in the elderly. Control of high blood pressure generally becomes easier over time, and excessive reduction occurs more as patients grow older. Elderly people in general are much more likely than younger people to get serious unwanted side effects, even from correct medication, and are more likely to make mistakes and to be targets for thoughtless repeat prescribing, by a variety of uncoordinated agencies.
