Hypertension in older people

‘Hypertension in older people’ highlights the issues concerning ageism in the diagnosis and management of hypertension, the prevalence, future predictions, and its historical aspects. Stroke is a disease of old age. The average age of stroke patients passing through our stroke unit is 76 years, in common with other units in the United Kingdom. Trials examining only those patients under 80 years old are examining a skewed population, in which around 40% of patients have been excluded. The author examines several trials of blood pressure lowering in older people, age related changes in blood pressure, the importance of systolic versus diastolic hypertension, targets of blood pressure control, impact of frailty, dementia, and cognitive impairment, orthostatic hypotension, and diabetes. Post-stroke blood pressure management is discussed in greater detail along with a review of the important trials in this group of patients.