Treatment of Renovascular and Adrenocortical Hypertension in the Elderly

J. David Spence, MD, FRCPC, Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, London, ON.

Effective treatment of hypertension is even more beneficial in the elderly than in younger patients because the elderly have a higher absolute risk of vascular events. Treating hypertension not only prevents stroke, but also reduces risk of dementia. Effective blood pressure control is based on identifying and treating its physiological cause. Renal hypertension, primary hyperaldosteronism and renal tubular abnormalities such as Liddle's syndrome can be identified by measuring the plasma renin and aldosterone. Most elderly patients require diuretic therapy for control, but most will require additional drugs to achieve the lower targets now supported by evidence.
Key words: hypertension, elderly, adrenocortical, renovascular.