ABSTRACT
Hypertension is a major risk factor for cardiovascular disease and is present in 69% of patients with a first myocardial infarction (MI), in 77% of patients with a first stroke, in 74% of patients with chronic heart failure, and in 60% of patients with peripheral arterial disease. Double-blind, randomized, placebo-controlled trials have demonstrated that antihypertensive drug therapy reduces cardiovascular events in elderly patients. The optimal blood pressure (BP) treatment goal in the elderly should be <130/80 mmHg.Nonpharmacologic lifestyle measures should be encouraged both to prevent the development of hypertension and as adjunctive therapy in persons with hypertension. Diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and calcium channel blockers have all shown benefit in reducing cardiovascular events in randomized trials. The choice of specific drugs depends on efficacy, tolerability, presence of specific comorbidities, and cost.
