Low-dose thiazide diuretics remain first-line therapy for older patients. In Nelson RG, Knowler WC, Petritt DJ, Bennett PH: Kidney disease in diabetes. By 2030, the U.S. population of persons who are older than 65 years is expected to double to more than 60 million.Isolated systolic blood pressure should be the primary target for diagnosis and management in older persons.The recommended blood pressure goal in older persons is less than 140/90 mm Hg.The recommended blood pressure goal in persons with diabetes or chronic kidney disease is less than 130/80 mm Hg.Studies in diabetes mellitus and chronic kidney disease were not specifically in older persons.There is no age threshold beyond which hypertension should not be treated.Thiazide diuretics are first-line therapy for isolated systolic hypertension, and they should be considered in any antihypertensive regimen in older persons.Isolated systolic blood pressure should be the primary target for diagnosis and management in older persons.The recommended blood pressure goal in older persons is less than 140/90 mm Hg.The recommended blood pressure goal in persons with diabetes or chronic kidney disease is less than 130/80 mm Hg.Studies in diabetes mellitus and chronic kidney disease were not specifically in older persons.There is no age threshold beyond which hypertension should not be treated.Thiazide diuretics are first-line therapy for isolated systolic hypertension, and they should be considered in any antihypertensive regimen in older persons.Multiple studies have demonstrated that isolated elevated systolic blood pressure is more prevalent in older persons because of increased large-artery stiffness.Measurements may be inaccurate because of pseudohypertension, in which the blood pressure cuff fails to compress a calcified artery. If after a trial period of behavioral treatment, blood pressure remains >130 mmHg systolic or >80 mmHg diastolic, pharmacological treatment should be added.Patients with confirmed blood pressures of ≥140/90 mmHg are candidates for immediate pharmacological treatment in addition to behavioral treatment. Hypertension is common in Hong Kong. Dr. Gibson also completed a family practice residency at Duke University Medical Center in Durham, N.C.The authors indicate that they do not have any conflicts of interest. Additional indications for use of beta blockers in older persons include high risk for coronary disease and prevention of a second myocardial infarction and heart failure Diuretic, ACE inhibitor, beta blocker, ARB, or aldosterone antagonistACE inhibitor, beta blocker, or aldosterone antagonistDiuretic, beta blocker, ACE inhibitor, or calcium channel blockerDiuretic, beta blocker, ACE inhibitor, ARB, or calcium channel blockerDiuretic for most; consider ACE inhibitor, ARB, beta blocker, calcium channel blocker, or combinationTwo-drug combination for most: diuretic plus ACE inhibitor, ARB, beta blocker, or calcium channel blockerTwo-drug combination for most: diuretic plus treatment for stage 1 hypertensionDiuretic, ACE inhibitor, beta blocker, ARB, or aldosterone antagonistACE inhibitor, beta blocker, or aldosterone antagonistDiuretic, beta blocker, ACE inhibitor, or calcium channel blockerDiuretic, beta blocker, ACE inhibitor, ARB, or calcium channel blockerDiuretic for most; consider ACE inhibitor, ARB, beta blocker, calcium channel blocker, or combinationTwo-drug combination for most: diuretic plus ACE inhibitor, ARB, beta blocker, or calcium channel blockerTwo-drug combination for most: diuretic plus treatment for stage 1 hypertensionBeta blockers that are lipophilic (e.g., propranolol [Inderal]) cross the blood-brain barrier, possibly causing more sedation, depression, and sexual dysfunction in older patients.Pharmacologic inhibition of the renin-angiotensin-aldosterone system can occur by inhibiting the formation of angiotensin II with an ACE inhibitor or by blocking the receptor site with an ARB. 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