Therapeutic considerations for elderly hypertensives

Elderly hypertensives have special needs that may be more important than the therapeutic goals physicians tend to set for their patients. They often fear drug dependency or incapacitation much more than they fear death. Too frequently, they live on a fixed income, dependent on third-party payment for a limited number of drugs. They become confused easily and are prone to medication error. Their regimen should be simple and ritualistic (but not confining), and lifestyle modifications should be kept to a minimum. The physiological, biological, and pharmacological changes that occur with aging, coupled with the socioeconomic limitations common to the elderly in our society, mandate a holistic approach to their care to realize maximum therapeutic gains from the patient's perspective as well as the physician's.