[The treatment of hypertension in the elderly : can it be done safely?].

The treatment of arterial hypertension is important for the prevention of stroke and heart failure even in very old hypertensive patients, but represents a challenge in terms of safety and quality of life. Confirmation of the diagnosis with 24-hour ambulatory blood pressure (BP) monitoring or BP monitoring at home is important. A systolic BP of 150 mmHg (135-140 mmHg with out-of-office measures) is an acceptable cut-off value for both the diagnosis of hypertension and as a target for treatment. The fear of drug-induced orthostatic hypotension is only rarely a reason not to treat. However, in the context of co-morbidities, the risk of other side effects is considerable. Blood pressure may decrease over time, reducing the requirements for anti-hypertensive therapy. Cautious drug prescription, avoiding exceedingly intensive treatments plans, is important for treatment adequacy and safety.