[Significance of arterial hypertension in geriatric prevention]

In Germany for decades the assessment and treatment of patients with high blood pressure is not satisfactory. As in other industrial countries only approximately 50% of hypertensive men and 60% of hypertensive women are diagnosed. Arterial hypertension bears the known risks on heart and vascular system also in old age when often target organ damages are already present. A sufficient number of clinical studies proves risk reduction by blood pressure lowering treatment. According to the criteria of WHO in old age the same limits of normal blood pressure and the same stages of the disease are valid as in younger patients. The probability of cardiovascular complications increases with the height of blood pressure. As small increases of blood pressure are far more prevalent than very high blood pressure values the cumulative risk in populations is predominantly linked to mild hypertension. In elderly patients systolic blood pressure has a better predictive value than diastolic blood pressure. A short review is given of work up and treatment of hypertension in the elderly instructed by the Guidelines of the German Hypertension Society.