Potential adverse effects of antihypertensive drugs in the elderly.

Antihypertensive therapy is effective in elderly patients, at least in those under 80 years old. Stepped care may still serve as a therapeutic framework which is modified to fit the individual elderly patient, according to the risk: benefit ratio. However, there are no risk-free drugs and no antihypertensive agent is universally effective. The elderly are probably more sensitive than younger patients to the adverse effects of antihypertensive drugs, for various reasons, among which are age- and disease-related changes that can lead to altered pharmacodynamics and pharmacokinetics. Multiple pathology and multiple drug therapy is likely to lead to an increased number of drug-drug and drug-disease interactions in the elderly. The elderly are probably most at risk from side effects that influence the cardiovascular and the central nervous system.