Treatment of hypertension in the elderly is a challenge. Elevated blood pressure (> 140/80 mmHg) in the elderly (60+ years) can be either systolic, diastolic or a combination of both. Arterial stiffness, intima hyperplasia and non-compliance of the vascular tree have been underlying factors. Prevalence of hypertension increases with advancing age and varies with the population under study, therefore screening this population should not only be limited to those at risk. Presentation is often due to complications such as stroke, cardiovascular events and erectile dysfunction or due to presentation of an un-related disorder. The presence of co-morbidity, drug interaction and their side effects should be considered in the management of hypertension in the elderly which has been shown to reduce morbidity and mortality. With the advent of several classes of antihypertensives, there is no shortage of drug options for treatment of hypertension in the elderly, but a careful and individualized approach is needed.
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