Treating Hypertension in the Elderly: Common Problems and Solutions

Hypertension is common in the elderly, and with an increasing ageing population in the industrialised world, has become a major public health issue. Hypertension in the elderly may have many different patterns of presentation such as Systolic-Diastolic Hypertension, Isolated Systolic Hypertension, Nocturnal Hypertension, Hypertension accompanied by Postural Hypotension and Supine Hypertension in the back ground of autonomic dysfunction. Management of hypertension in the elderly is not straightforward due to the presence of a variety of patterns of presentation, Pathophysiological changes associated with hypertension and aging, co-existing medical problems and Polypharmacy. This article deals with the management of commonly encountered problems such as orthostatic hypotension, orthostatic hypotesnion accompanied by supine hypertension, erectile dysfunction and also covers issues such as controversy surrounding the [alleged] association between hypertension and its treatment and the risk of dementia as well as management of hypertension in the very elderly.