Characteristics of an ideal antihypertensive therapy for elderly hypertensives

Treatment of hypertension in the elderly has become not only accepted but also a highly ethical, effective and compelling procedure following the many clearly positive reports on the benefits of lowering elevated arterial pressure in elderly patients. So far most intervention studies in elderly hypertensive patients have used diuretics or beta-blockers or the two in combination as the moiety by which blood pressure has been lowered. However, from a theoretical point of view, more novel therapies could offer advantages that would translate into an even better reduction of cardiovascular morbidity and mortality than has been obtained with the traditional antihypertensive therapies used so far. Some of the studies in elderly hypertensives that are in progress using angiotensin converting enzyme inhibitors or calcium antagonists as the main therapies, e.g. the STOP-Hypertension-2 Study and the Syst-Eur Study, will be briefly reviewed here as will the large data base on urapidil, a dual action antihypertensive drug used in the treatment of elderly hypertensives. By careful evaluation of the effects of novel antihypertensive drugs, and the already existing data base on urapidil in elderly hypertensive patients, it is likely that still better reduction of risk can be obtained in the elderly hypertensives by the use of more novel therapies than diuretics and beta-blockers.