Pathophysiology of blood pressure in the elderly

Several of the factors responsible for circulatory control are modified in the elderly. Loss of elasticity of the aortic wall produces a widened pulse pressure and a high incidence of systolic hypertension. Attempts to normalize this may be associated with disabling diastolic hypotension. Arterial baroreceptor sensitivity and responsiveness of the renin-angiotensin system is reduced. Further, the renal capacity to conserve sodium and water is impaired. All these increase the risks associated with antihypertensive treatment, but do not contra-indicate such treatment.