[Arterial hypertension in elderly patients - from pathophysiology to rational treatment]

According to the WHO, arterial hypertension is a major cause of death in adult populations all over the world, regardless of the socio-economic level of a specific population. In Poland, the presence of hypertension is estimated to be about 1/3 in the population of adult Poles. Although hypertension may occur in people of all ages, as the population is ageing, a large group of patients are those over 65. In this age group, the dominant form of arterial hypertension is the isolated systolic hypertension (ISH), in which increased systolic blood pressure is disclosed (higher than or equal to 140 mm Hg), with diastolic blood pressure values remaining within the normal range (<90 mm Hg). Even 15 years ago, the therapeutic approach to ISH in the elderly was a subject of a broad debate. Until the results of main clinical trials and meta-analyzes summarising these results were announced, it was not certain whether active treatment of these patients was beneficial. Moreover, the drug selection issue was hotly debated. The last major problem was the question concerning benefits resulting from the treatment of isolated systolic hypertension in patients aged 80 years and older.