Hypertension in the elderly: to treat or not to treat.

Hypertension is a common condition in the elderly. It is not a normal aging change and leads to serious sequelae at any age. Both diastolic/systolic hypertension and isolated systolic hypertension present serious risk at all ages, but the efficacy of therapy is more certain for the diastolic/systolic hypertension. Treatment consists of the usual non-drug therapy as well as the classic `stepped-care' approach. If therapy is sensible and careful, side effects of the drugs can be minimized and controlled. In choosing from among the numerous antihypertensive agents, the physician must consider patients' concomitant illnesses as well as drugs that they are already taking for other reasons.