Nutritional and behavioral measures in the non-pharmacological treatment of elderly hypertensive subjects

The antihypertensive treatments have resulted in favorable effects in terms of cardiovascular morbidity and mortality in the elderly, but the therapeutic approaches raise problems linked to the pathophysiological aspects of hypertensives and to the reduced homoeostatic capacity of the senile organism. The antihypertensive treatment in elderly must be aimed at achieving a maximal improvement in the cardiovascular risk profile with possibly minimal side effects. The first step is the non-pharmacological therapy which is a hygienic-behavioral program aimed at changing the patient's life style (physical exercise, reduced salt intake, body weight control, etc.). Non-pharmacological therapy in the elderly patients requires a preliminary evaluating protocol and a close monitoring of the individual responses. The diet, restriction of sodium intake (4-6 g/day), and aerobic physical exercise are important for decrease the development and persistence of hypertension. The non-pharmacological therapy has a low antihypertensive action, however, once established, it should not be abandoned, as its association with pharmacological treatment allows the use of fewer and lower doses of drugs, with a consequent reduction of the risks due to side effects.