Antihypertensive treatment guideline for elderly hypertension

Recently published Hypertension Treatment Guideline by Japanese Society of Hypertension (JSH2000) contains several unique suggestions for treatment of elderly hypertension in particular. In general, the therapeutic goal of blood pressure in the elderly is set at a higher level than that in the young. For the patients of age 70 and over blood pressure should be controlled less than 150-160 mmHg. The following drugs are recommended as the first line drug in the elderly hypertension: 1. long-acting Ca antagonists, 2. ACE inhibitors (or angiotensin II antagonists) and 3. small dose of diuretics. Combination therapy should be considered when monotherapy of more than 2 to 3 months is not successful to reduce blood pressure below 150/90 mmHg.