Turning up the heat on hypertension. It's time to be more aggressive in finding and treating this silent killer.

Treatment of high blood pressure can be challenging. Most patients have no symptoms and are unlikely to appreciate the value of antihypertensive medications. Unless acute target organ involvement is already present, there are no compelling reasons to lower blood pressure quickly. Instead, beginning with relatively low doses of medications and slowly bringing the blood pressure to goal helps avoid troublesome medication side effects. This is especially important in elderly patients with isolated systolic hypertension who are susceptible to orthostatic hypotension, dizziness, and confusion, despite little change in blood pressure. Use of long-acting agents and combination medications may improve compliance with the medical regimen.