Hypertension in Elderly – Pathogenesis and Treatment

Abstract

“Old age is like a plane flying through a storm. Once you’re aboard, there’s nothing you can do.” -Golda Meir Hypertension (HTN) is a leading risk factor in the aged for cardio/cerebrovascular events, the prevalence of which increases with age. Pathophysiologically, it differs from HTN of the young (altered structure and function of conduit arteries vis-a-vis resistance vessels of the young). Older hypertensives have altered or downregulated biological functions, have multiple comorbidities warranting polypharmacy with attendant drug interactions� Elevated blood pressure (BP) is the most common cause of mortality over the globe, being responsible for about 13% of all deaths every year, accounting for about 57 million disability-adjusted life years�[1] The prevalence of elevated BP worldwide in 2008 was about 40%, being highest in the WHO African region (46%) and lowest in the Americas (35% in both sexes). The prevalence of uncontrolled HTN has increased by approximately 600 million compared to that in 1980�[2] The burden of HTN is rising globally due to the growth of the obese and aged population and is projected to affect around 70% of the global population by 2025�[3] Abstract