Hypertension in the elderly
The prevalence of hypertension and, particularly, of isolated systolic hypertension increases with aging.
On the physiopathological ground, senile hypertension is associated with a decreased compliance of aorta and large vessels, and with dysfunctions of the baroreceptorial reflexes and of some hormonal systems, causing an impaired homeostasis of the body fluids.
On the clinical ground, hypertension in the elderly is characterized by an increased pressor values variability, with a higher prevalence of hypertensive and hypotensive crises, which, in presence of blunted mechanisms of the peripheral blood flow regulation, can induce local ischemia symptoms.
On the therapeutical ground, caution must be due in the pharmacological treatment of elderly patients, also considering the specific complications of hypertension, the associated diseases and the higher incidence of the side effects of the drugs.
In this paper the above-mentioned topics are discussed underlining the opportunity of a careful and individual clinical evaluation.
KeywordsSystolic Hypertension Blood Pressure Variability Baroreceptorial Reflex European Working Party Systolic Blood Pressure Increase
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