The risk of cardiovascular disease increases with blood pressure at all ages and in both sexes.1 The risk of stroke2 and heart failure is especially high in older hypertensive patients. However, treating raised blood pressure in the elderly poses problems: they are at especial risk from unwanted effects of drugs and from interactions with drugs taken for other diseases; it may be more difficult to ensure treatment is taken regularly; and, as systolic blood pressure rises with age partly because the arterial walls lose elasticity, the definition of hypertension in older patients is less certain. As with mild hypertension in younger patients, the clinical problem is to determine at what level of blood pressure and in which particular patients the benefits from treatment outweigh the disadvantages.3
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