The elderly hypertensive; cardiovascular and neurohormonal profile

In this paper, a brief review is presented on the hemodynamic and neurohormonal changes in the elderly hypertensive patient. Arterial stiffening leads to a predominant rise in systolic pressure and a widening of pulse pressure. This in itself contributes to an increased cardiovascular risk in the elderly. In addition, there is a progressive decline in renal perfusion with, later on, a fall in glomerular filtration rate. The renal vascular changes may impair the kidney's ability to adequately maintain sodium balance under conditions of salt loading or restriction. The neurohormonal alterations generally include suppression and reduced responsiveness of the renin system and a decline in sympathetic activity.