[Hypertension in the aged: when to treat it?]

According to several recent studies prevalence of hypertension in the elderly ranges from 40 to 60%. Both, systolic as well as diastolic increase of blood pressure must be regarded as individual cardiovascular risk factors. Treatment of hypertension in the elderly gains special importance in the presence of additional risk factors. There is no doubt about the benefit of antihypertensive therapy when the diastolic value amounts to 100 mmHg and more. No reliable data exist so far on a beneficial effect of the treatment of systolic hypertension. Whether hypertensive patients older than 80 years and patients with only marginal increases of blood pressure benefit from antihypertensive treatment has not been proven by current studies. If the patient's anamnesis includes cerebral stroke a cautious antihypertensive therapy may reduce cardial insufficiency without increasing the risk for another apoplexia.