Chinese expert consensus on the management of hypertension in the very eld-erly

There is still a gap in the management of hypertension between octogenarians and routine population because of insufficient evidence. The success rate of treating hypertension in the elderly population is lower than those patients below the age of 80. We discussed the definition，characteristics and management for hypertension in the very elderly. The characteristics are isolated elevation in systolic BP, increased pulse pressure, abnormal circadian rhythm, large fluctuations of BP, multi risk factors coexisted, many concomitant accompanied, target organs severely damaged and so on. According to this consensus, general condition, co-existing disease, the risk of treatment and tolerance of medication should be considered in order to make a decision regarding the initiation treatment. During treatment, the effect from BP drop should be monitored and the tolerance should be considered for the purpose of titrating the medication. Life style modification is recommended for those patients who are not appropriate for medications. BP monitoring, regular follow up, and re-evaluation are necessary. BP level of initial treatment is greater than or equal to160/90 mmHg. And different target BP is recommended for patients with co-existing disease.